Y Shape Osteotomy in Ankylosing Spondylitis, a Prospective Case Series with Minimum 2 Year Follow-Up

<div><p>The aim of the study is to evaluate the efficacy of a spinal osteotomy technique, Y shape osteotomy, for correcting kyphosis in AS patients planned preoperatively with computer software-assistance. 36 consecutive AS patients with thoracolumbar kyphosis were treated with one-stage posterior Y shape osteotomy and preoperative surgical planning was done with the aid of the Surgimap Spine. Radiological parameters of simulation and immediate postoperation were documented. Clinical and radiological results were evaluated in the preoperative, the early postoperative periods and during the last follow-up. The lumbar lordosis was found as 40.7 ± 4.1 degrees in the surgical planning and 49.7 ± 3.9 degrees postoperatively (p<0.01). PI-LL was 3.8± 0.9°in the simulation procedure and 6.6± 1.5°postoperatively (p<0.01). At the final follow-up, Global sagittal balance was restored and Both Oswestry Disability Index and Scoliosis Research Society scores improved largely. In conclusion, Y shape osteotomy is a safe and effective treatment option for AS patients with kyphosis deformity.</p></div

The preoperative and last follow-up data of patients with AS.

<p>The preoperative and last follow-up data of patients with AS.</p

Patient demographics.

<p>Patient demographics.</p

The simulation of Y shape osteotomy in surgimap for patients with AS.

<p>(A) Spino- pelvic parameters were measured and analyzed; (B) “Wedge Osteotomy” was applied at the posterior column of L2; (C) radiographic image after simulated osteotomy.</p

Y shape osteotomy.

<p>(A) ‘Y’ type osteotomy was achieved; (B) the posterior wedge space was closed with appropriate opening of the anterior column; (C) intra-operative imaging shows L1 Y shape osteotomy</p

The patient is placed prone on a radiolucent operating table

<p>The patient is placed prone on a radiolucent operating table</p

Pre- and post-operative radiological outcomes.

<p>(A, B, C) AP and lateral standing radiographs and sagittal CT scan of a 36-year-old man with thoracolumbar kyphosis secondary to ankylosing spondylitis; (D, E, F): Y shape osteotomy was performed at L2, and Two years of follow-up revealed the normal sagittal alignment was achieved.</p

DataSheet1_Genetic association of hypertension and several other metabolic disorders with Bell’s palsy.docx

Background: Effects of hypertension, type 2 diabetes and obesity on Bell’s palsy risk remains unclear. The aim of the study was to explore whether hypertension and these metabolic disorders promoted Bell’s palsy at the genetic level.Methods: Genetic variants from genome-wide association studies for hypertension, type 2 diabetes, body mass index and several lipid metabolites were adopted as instrumental variables. Two-sample Mendelian randomization including IVW and MR-Egger was used to measure the genetic relationship between the exposures and Bell’s palsy. Sensitivity analyses (i.e., Cochran’s Q test, MR-Egger intercept test, “leave-one-SNP-out” analysis and funnel plot) were carried out to assess heterogeneity and horizontal pleiotropy. All statistical analyses were performed using R software.Results: Hypertension was significantly associated with the increased risk of Bell’s palsy (IVW: OR = 2.291, 95%CI = 1.025–5.122, p = 0.043; MR-Egger: OR = 16.445, 95%CI = 1.377–196.414, p = 0.029). Increased level of LDL cholesterol might upexpectedly decrease the risk of the disease (IVW: OR = 0.805, 95%CI = 0.649–0.998, p = 0.048; MR-Egger: OR = 0.784, 95%CI = 0.573–1.074, p = 0.132). In addition, type 2 diabetes, body mass index and other lipid metabolites were not related to the risk of Bell’s palsy. No heterogeneity and horizontal pleiotropy had been found.Conclusion: Hypertension might be a risk factor for Bell’s palsy at the genetic level, and LDL cholesterol might reduce the risk of the disease. These findings (especially for LDL cholesterol) need to be validated by further studies.</p

DataSheet2_Genetic association of hypertension and several other metabolic disorders with Bell’s palsy.docx

Background: Effects of hypertension, type 2 diabetes and obesity on Bell’s palsy risk remains unclear. The aim of the study was to explore whether hypertension and these metabolic disorders promoted Bell’s palsy at the genetic level.Methods: Genetic variants from genome-wide association studies for hypertension, type 2 diabetes, body mass index and several lipid metabolites were adopted as instrumental variables. Two-sample Mendelian randomization including IVW and MR-Egger was used to measure the genetic relationship between the exposures and Bell’s palsy. Sensitivity analyses (i.e., Cochran’s Q test, MR-Egger intercept test, “leave-one-SNP-out” analysis and funnel plot) were carried out to assess heterogeneity and horizontal pleiotropy. All statistical analyses were performed using R software.Results: Hypertension was significantly associated with the increased risk of Bell’s palsy (IVW: OR = 2.291, 95%CI = 1.025–5.122, p = 0.043; MR-Egger: OR = 16.445, 95%CI = 1.377–196.414, p = 0.029). Increased level of LDL cholesterol might upexpectedly decrease the risk of the disease (IVW: OR = 0.805, 95%CI = 0.649–0.998, p = 0.048; MR-Egger: OR = 0.784, 95%CI = 0.573–1.074, p = 0.132). In addition, type 2 diabetes, body mass index and other lipid metabolites were not related to the risk of Bell’s palsy. No heterogeneity and horizontal pleiotropy had been found.Conclusion: Hypertension might be a risk factor for Bell’s palsy at the genetic level, and LDL cholesterol might reduce the risk of the disease. These findings (especially for LDL cholesterol) need to be validated by further studies.</p

Additional file 3: of Characterization of a new apple luteovirus identified by high-throughput sequencing

Verification of graft transmission of apple luteovirus 1 to apple seedlings by RT-PCR using primers AluDetF6/R6 (Additional file 1). Lanes M) 1 kb plus DNA ladder; 1–3) from PA13; 4–6) from PA14; 7–9) from PA18; 10–12) from PA21; 13) PA14; 14) water. Arrow indicate the DNA fragment with labeled size. (PPTX 157 kb