Evaluation of unilateral cage-instrumented fixation for lumbar spine

<p>Abstract</p> <p>Background</p> <p>To investigate how unilateral cage-instrumented posterior lumbar interbody fusion (PLIF) affects the three-dimensional flexibility in degenerative disc disease by comparing the biomechanical characteristics of unilateral and bilateral cage-instrumented PLIF.</p> <p>Methods</p> <p>Twelve motion segments in sheep lumbar spine specimens were tested for flexion, extension, axial rotation, and lateral bending by nondestructive flexibility test method using a nonconstrained testing apparatus. The specimens were divided into two equal groups. Group 1 received unilateral procedures while group 2 received bilateral procedures. Laminectomy, facectomy, discectomy, cage insertion and transpedicle screw insertion were performed sequentially after testing the intact status. Changes in range of motion (ROM) and neutral zone (NZ) were compared between unilateral and bilateral cage-instrumented PLIF.</p> <p>Results</p> <p>Both ROM and NZ, unilateral cage-instrumented PLIF and bilateral cage-instrumented PLIF, transpedicle screw insertion procedure did not revealed a significant difference between flexion-extension, lateral bending and axial rotation direction except the ROM in the axial rotation. The bilateral group's ROM (-1.7 ± 0. 8) of axial rotation was decreased significantly after transpedicle screw insertion procedure in comparison with the unilateral group (-0.2 ± 0.1). In the unilateral cage-instrumented PLIF group, the transpedicle screw insertion procedure did not demonstrate a significant difference between right and left side in the lateral bending and axial rotation direction.</p> <p>Conclusions</p> <p>Based on the results of this study, unilateral cage-instrumented PLIF and bilateral cage-instrumented PLIF have similar stability after transpedicle screw fixation in the sheep spine model. The unilateral approach can substantially reduce exposure requirements. It also offers the biomechanics advantage of construction using anterior column support combined with pedicle screws just as the bilateral cage-instrumented group. The unpleasant effect of couple motion resulting from inherent asymmetry was absent in the unilateral group.</p

Loading effects of anterior cervical spine fusion on adjacent segments

AbstractAdjacent segment degeneration typically follows anterior cervical spine fusion. However, the primary cause of adjacent segment degeneration remains unknown. Therefore, in order to identify the loading effects that cause adjacent segment degeneration, this study examined the loading effects to superior segments adjacent to fused bone following anterior cervical spine fusion. The C3–C6 cervical spine segments of 12 sheep were examined. Specimens were divided into the following groups: intact spine (group 1); and C5–C6 segments that were fused via cage-instrumented plate fixation (group 2). Specimens were cycled between 20° flexion and 15° extension with a displacement control of 1°/second. The tested parameters included the range of motion (ROM) of each segment, torque and strain on both the body and inferior articular process at the superior segments (C3–C4) adjacent to the fused bone, and the position of the neutral axis of stress at under 20° flexion and 15° extension. Under flexion and Group 2, torque, ROM, and strain on both the bodies and facets of superior segments adjacent to the fused bone were higher than those of Group 1. Under extension and Group 2, ROM for the fused segment was less than that of Group 1; torque, ROM, and stress on both the bodies and facets of superior segments adjacent to the fused bone were higher than those of Group 1. These analytical results indicate that the muscles and ligaments require greater force to achieve cervical motion than the intact spine following anterior cervical spine fusion. In addition, ROM and stress on the bodies and facets of the joint segments adjacent to the fused bone were significantly increased. Under flexion, the neutral axis of the stress on the adjacent segment moved backward, and the stress on the bodies of the segments adjacent to the fused bone increased. These comparative results indicate that increased stress on the adjacent segments is caused by stress-shielding effects. Furthermore, increased stress and ROM of the adjacent segments after long-term bone fusion may accelerate degeneration in adjacent segment

A User-Centered Mapping Design for Geomorphological Hazard Thematic Map

Numerous studies have concentrated on developing user-centered designs for hazard zone maps but rarely for hazard-oriented geomorphological maps, named as Geomorphological Hazard Thematic Maps (GHTMs) in this study, which provide more detailed information about natural hazards. This study developed a user-centered mapping design for GHTMs for nonexperts in geomorphology. We invited civil engineers and high school educators to evaluate a sample GHTM\u27s design in group and focus group panel interviews. The civil engineers preferred maps with more geomorphological features, whereas the educators preferred simple designs. Both groups indicated that the inclusion of essential facilities and road networks is essential. The map was also adjusted by adding hillshade layer and by changing the symbology for mass wasting, fault scarps, and fluvial features to increase clarity and simplicity. This case study is the first step toward developing user-centered mapping designs for hazard communication that will deepen their understanding of natural hazards

Pseudospin symmetry and its approximation in real nuclei

The origin of pseudospin symmetry and its broken in real nuclei are discussed in the relativistic mean field theory. In the exact pseudospin symmetry, even the usual intruder orbits have degenerate partners. In real nuclei, pseudospin symmetry is approximate, and the partners of the usual intruder orbits will disappear. The difference is mainly due to the pseudo spin-orbit potential and the transition between them is discussed in details. The contribution of pseudospin-orbit potential for intruder orbits is quite large, compared with that for pseudospin doublets. The disappearance of the pseudospin partner for the intruder orbit can be understood from the properties of its wave function.Comment: 10 pages, 3 figure

Ankle-Brachial Index Is a Powerful Predictor of Renal Outcome and Cardiovascular Events in Patients with Chronic Kidney Disease

Ankle-brachial index (ABI) is an accurate tool to diagnose peripheral arterial disease. The aim of this study was to evaluate whether ABI is also a good predictor of renal outcome and cardiovascular events in patients with chronic kidney disease (CKD). We enrolled 436 patients with stage 3–5 CKD who had not been undergoing dialysis. Patients were stratified into two groups according to the ABI value with a cut point of 0.9. The composite renal outcome, including doubling of serum creatinine level and commencement of dialysis, and the incidence of cardiovascular events were compared between the two groups. After a median follow-up period of 13 months, the lower ABI group had a poorer composite renal outcome (OR = 2.719, P = 0.015) and a higher incidence of cardiovascular events (OR = 3.260, P = 0.001). Our findings illustrated that ABI is a powerful predictor of cardiovascular events and renal outcome in patients with CKD

KCNN2 polymorphisms and cardiac tachyarrhythmias

Potassium calcium-activated channel subfamily N member 2 (KCNN2) encodes an integral membrane protein that forms small-conductance calcium-activated potassium (SK) channels. Recent studies in animal models show that SK channels are important in atrial and ventricular repolarization and arrhythmogenesis. However, the importance of SK channels in human arrhythmia remains unclear. The purpose of the present study was to test the association between genetic polymorphism of the SK2 channel and the occurrence of cardiac tachyarrhythmias in humans. We enrolled 327 Han Chinese, including 72 with clinically significant ventricular tachyarrhythmias (VTa) who had a history of aborted sudden cardiac death (SCD) or unexplained syncope, 98 with a history of atrial fibrillation (AF), and 144 normal controls. We genotyped 12 representative tag single nucleotide polymorphisms (SNPs) across a 141-kb genetic region containing the KCNN2 gene; these captured the full haplotype information. The rs13184658 and rs10076582 variants of KCNN2 were associated with VTa in both the additive and dominant models (odds ratio [OR] 2.89, 95% confidence interval [CI] = 1.505-5.545, P = 0.001; and OR 2.55, 95% CI = 1.428-4.566, P = 0.002, respectively). After adjustment for potential risk factors, the association remained significant. The population attributable risks of these 2 variants of VTa were 17.3% and 10.6%, respectively. One variant (rs13184658) showed weak but significant association with AF in a dominant model (OR 1.91, CI = 1.025-3.570], P = 0.042). There was a significant association between the KCNN2 variants and clinically significant VTa. These findings suggest an association between KCNN2 and VTa; it also appears that KCNN2 variants may be adjunctive markers for risk stratification in patients susceptible to SCD

Linking deeply-sourced volatile emissions to plateau growth dynamics in southeastern Tibetan Plateau

© The Author(s), 2021. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Zhang, M., Guo, Z., Xu, S., Barry, P. H., Sano, Y., Zhang, L., Halldorsson, S. A., Chen, A.-T., Cheng, Z., Liu, C.-Q., Li, S.-L., Lang, Y.-C., Zheng, G., Li, Z., Li, L., & Li, Y. Linking deeply-sourced volatile emissions to plateau growth dynamics in southeastern Tibetan Plateau. Nature Communications, 12(1), (2021): 4157, https://doi.org/10.1038/s41467-021-24415-y.The episodic growth of high-elevation orogenic plateaux is controlled by a series of geodynamic processes. However, determining the underlying mechanisms that drive plateau growth dynamics over geological history and constraining the depths at which growth originates, remains challenging. Here we present He-CO2-N2 systematics of hydrothermal fluids that reveal the existence of a lithospheric-scale fault system in the southeastern Tibetan Plateau, whereby multi-stage plateau growth occurred in the geological past and continues to the present. He isotopes provide unambiguous evidence for the involvement of mantle-scale dynamics in lateral expansion and localized surface uplift of the Tibetan Plateau. The excellent correlation between 3He/4He values and strain rates, along the strike of Indian indentation into Asia, suggests non-uniform distribution of stresses between the plateau boundary and interior, which modulate southeastward growth of the Tibetan Plateau within the context of India-Asia convergence. Our results demonstrate that deeply-sourced volatile geochemistry can be used to constrain deep dynamic processes involved in orogenic plateau growth.This work was supported by China Seismic Experimental Site (CSES) (2019CSES0104), the Strategic Priority Research Program (B) of Chinese Academy of Sciences (XDB26000000), the National Key Research and Development Program of China (2020YFA0607700), the National Natural Science Foundation of China (41930642, 41602341, 41772355, and 41702361), the Second Tibetan Plateau Scientific Expedition and Research Program (STEP) (2019QZKK0702), and the United Laboratory of High-Pressure Physics and Earthquake Science (2019HPPES02). P.H.B. was supported by the US National Science Foundation EAR Grant 1144559 during a portion of this work