Clinical Outcome and Complications of Transpedicular Closing-wedge Osteotomy for Correction of Deformity in Ankylosing Spondylitis in a Regional Hospital

Study design: Prospective study of surgical correction of thoracolumbar kyphotic deformity caused by ankylosing spondylitis. Objectives: To assess surgical outcomes and complications of thoracolumbar kyphotic deformity corrected with transpedicular closing-wedge osteotomy performed in a regional hospital. Summary of background data: There have been several studies reporting on the results of surgical correction of deformity in ankylosing spondylitis all over the world. However, there has not been any local data published. Methods: From 2003 to 2011, we had performed 12 transpedicular closing-wedge osteotomies in 9 patients with ankylosing spondylitis for correction of kyphotic and scoliotic deformity in thoracolumbar spine. Operative outcomes were assessed clinically by recording the Japanese Orthopaedic Association (JOA) scores, visual analogue scale (VAS) pain scores, Oswestry Disability Index (ODI) preoperatively and postoperatively and patient satisfaction postoperatively. Radiological outcome was assessed by measuring thoracic kyphosis, lumbar lordosis and sagittal plumb line preoperatively and postoperatively as well as the degree of surgical correction. Occurrence of complications was recorded by our standard audit protocol. Results: All patients had a single level of osteotomy done at a time. Most of the osteotomies were done at L2 or L3. The mean amount of correction was 21.6°. Complications included dural tear, pseudoarthrosis and transient radiculopathy. The extent of correction and incidence of complications improved with experience. Conclusion: Despite transpedicular closing-wedge osteotomy being a major operation that is not without complications, most of our patients had good clinical results and subjective satisfaction

Mucormycosis Vertebral Osteomyelitis

Fungal vertebral osteomyelitis by mucormycosis is extremely rare. We report a 16-year-old patient with newly diagnosed acute lymphoid leukaemia who developed extensive vertebral osteomyelitis caused by mucormycosis. He was treated with three-level subtotal spondylectomy and long-term oral antifungal medications. He had no neurological deficit after the operation. 中 文 摘 要: 由毛霉菌引致的真菌性脊椎骨髓炎是非常罕見的。我們執告一例16歲剛診斷急性淋巴白血病患者由毛霉菌引起的廣泛脊髓骨髓炎。治療包括三節次全脊椎切除術及長期口服抗真菌藥物。手術後，沒有神經功能缺損。 Keywords: fungal infections, mucormycosis, osteomyelitis, spinal infection

Development of a Novel, Genome Subtraction-Derived, SARS-CoV-2-Specific COVID-19-nsp2 Real-Time RT-PCR Assay and Its Evaluation Using Clinical Specimens

The pandemic novel coronavirus infection, Coronavirus Disease 2019 (COVID-19), has affected at least 190 countries or territories, with 465,915 confirmed cases and 21,031 deaths. In a containment-based strategy, rapid, sensitive and specific testing is important in epidemiological control and clinical management. Using 96 SARS-CoV-2 and 104 non-SARS-CoV-2 coronavirus genomes and our in-house program, GolayMetaMiner, four specific regions longer than 50 nucleotides in the SARS-CoV-2 genome were identified. Primers were designed to target the longest and previously untargeted nsp2 region and optimized as a probe-free real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. The new COVID-19-nsp2 assay had a limit of detection (LOD) of 1.8 TCID50/mL and did not amplify other human-pathogenic coronaviruses and respiratory viruses. Assay reproducibility in terms of cycle threshold (Cp) values was satisfactory, with the total imprecision (% CV) values well below 5%. Evaluation of the new assay using 59 clinical specimens from 14 confirmed cases showed 100% concordance with our previously developed COVID-19-RdRp/Hel reference assay. A rapid, sensitive, SARS-CoV-2-specific real-time RT-PCR assay, COVID-19-nsp2, was developed