Clinical and radiographic outcomes of the treatment of adolescent idiopathic scoliosis with segmental pedicle screws and combined local autograft and allograft bone for spinal fusion: a retrospective case series

<p>Abstract</p> <p>Background</p> <p>High morbidity has been reported with iliac crest bone graft harvesting; however, donor bone is typically necessary for posterior spinal fusion. Autograft bone combined with allograft may reduce the morbidity associated with iliac crest bone harvesting and improve the fusion rate. Our aim in this study was to determine the presence of complications, pseudarthrosis, non-union, and infection using combined <it>in situ </it>local autograft bone and freeze-dried cancellous allograft bone in patients undergoing posterior spinal fusion for the treatment of adolescent idiopathic scoliosis.</p> <p>Methods</p> <p>A combination of <it>in situ </it>local autograft bone and freeze-dried cancellous allograft blocks were used in 50 consecutive patients with adolescent idiopathic scoliosis treated by posterior fusion and Moss Miami pedicle screw instrumentation. Results were assessed clinically and radiographically and quality of life and functional outcome was evaluated by administration of a Chinese version of the SRS-22 survey.</p> <p>Results</p> <p>There were 41 female and 9 male patients included for analysis with an average age of 14.7 years (range, 12-17). All patients had a minimum follow-up of 18 months (range, 18 to 40 months). The average preoperative Cobb angle was 49.8° (range, 40° to 86°). The average number of levels fused was 9.8 (range, 6-15). Patients had a minimum postoperative follow-up of 18 months. At final follow-up, the average Cobb angle correction was 77.8% (range, 43.4 to 92.5%). There was no obvious loss in the correction, and the average loss of correction was 1.1° (range, 0° to 4°). There was no pseudarthrosis and no major complications.</p> <p>Conclusions</p> <p><it>In situ </it>autograft bone combined with allograft bone may be a promising method enhances spinal fusion in AIS treated with pedicle screw placement. By eliminating the need for iliac crest bone harvesting, significant morbidity may be avoided.</p

Anterior Lumbar Interbody Fusion for Degenerative Discogenic Low Back Pain: Evaluation of L4–S1 Fusion

Abstract The treatment of degenerative discogenic pain is controversial, and anterior lumbar fusion for the treatment of degenerative discogenic low back pain has also been a controversial topic for over a generation. The aim of this systematic review was to evaluate the outcome of different anterior lumbar fusion levels for degenerative discogenic low back pain. In this study, we performed a clinical outcome subgroup analysis. The outcomes of 84 consecutive patients who underwent anterior lumbar interbody fusion from 2004 to 2009 were reviewed. The operative time, intraoperative blood loss, hospital stay, Oswestry Disability Index (ODI), visual analog scale (VAS) results, and complication rate were recorded separately. Medical indications were degenerative disc disease (73.8%), postdiscectomy disc disease (16.1%), and disc herniation (9.5%). Patients with severe spondylolysis or disc degeneration, with more than 3 or multilevel lesions, were excluded. The mean operative time was 124.5 ± 10.9 min (range 51–248 min), the mean intraoperative blood loss was 242.1 ± 27.7 mL (range 50–2700 mL), the mean hospital stay was 3.9 ± 1.1 days (range 3–6 days), the mean preoperative VAS score was 7.5 ± 1.4, and the mean preoperative ODI score was 60.0 ± 5.7. At the 1-year follow-up, the mean postoperative VAS score was 3.3 ± 1.3 and the mean postoperative ODI score was 13.6 ± 3.4 (P < 0.05). L4–L5 disc fusion led to better clinical results than 2-level L4–L5/L5–S1 disc fusion. Additionally, the 2-level fusion of L4–L5/L5–S1 had better clinical results than the L5–S1 disc fusion at both the 1 and 2-year postoperative follow-ups regarding the VAS score and the ODI score. The rate of complications was more frequent in the 2-level L4–L5/L5–S1 group (27.3%) (group C) than in the L4–L5 group (9.1%) (group A) and the L5–S1 group (12.5%) (group B). There was no difference between the L4–L5 group (9.1%) and the L5–S1 group (12.5%). A venous tear occurred during surgery and was successfully repaired in 6 of the 84 patients. Also, out of the 84 patients, 6 were found with pseudarthrosis during the follow-up, and these patients underwent a spinal fusion with instrumentation, with a posterior approach after a mean of 1 year. The complications secondary to the surgical approach were persistent abdominal pain (1/84, 1.2%) and wound dehiscence (1/84, 1.2%). Anterior lumbar interbody fusion for L4–L5 had better clinical results than the 2-segmental L4–L5/L5–S1 disc fusion, and the 2-segmental L4–L5/L5–S1 disc fusion had better clinical results than the L5–S1 disc fusion. Also, the 2-segmental L4–L5/L5–S1 disc fusion had a higher complication rate (27.3%), but there was no difference between the L4–L5 group (9.1%) and the L5–S1 group (12.5%)

Photocatalytic Degradation and Antibacterial Properties of Fe3+-Doped Alkalized Carbon Nitride

Discovering novel materials and improving the properties of existing materials are the main goals in the field of photocatalysis to increase the potential application of the materials. In this paper, a modified graphitic carbon nitride (g-C3N4) photocatalyst named Fe3+-doped alkalized carbon nitride, which couples the photocatalytic reaction with the Fenton reaction, is introduced to demonstrate its Rhodamine B (RhB) degradation and antibacterial properties. Under visible-light irradiation, the degradation rate of RhB was 99.9% after 200 min, while the antibacterial rates of Pseudomonas aeruginosa (P. aeruginosa), Escherichia coli (E. coli), and Staphylococcus aureus (S. aureus) after 300 min were 99.9986%, 99.9974%, and 99.9876%, respectively. Moreover, the repetitive experiments of RhB degradation demonstrate that the proposed photocatalysts have excellent stability and reusability. The active free radical trapping experiments reveal that the superoxide radical (&middot;O2&minus;) is the dominant reactive oxygen species. In addition, the Fenton reaction is introduced into the photocatalytic system due to the doping of Fe3+, and the hydroxyl radical (&middot;OH) produced from the Fenton reaction further enhances the photocatalytic performance. The remarkable improvement in photocatalytic performance of the proposed photocatalyst can be attributed to its broader UV&ndash;visible absorption characteristic and the occurrence of the Fenton reaction

Developing high photocatalytic antibacterial Zn electrodeposited coatings through Schottky junction with Fe3+-doped alkalized g-C3N4 photocatalysts

Pure Zn coatings easily lose their protective performance after biofouling because they have no antibacterial effect under visible light. In this study, we fabricate a new antibacterial Zn composite coating using electrodeposition to couple Fe3+-doped alkalized g-C3N4 (AKCN-Fe) into an existing Zn coating and show that the AKCN-Fe enhances antibacterial property of the Zn coating under visible light. We attribute this enhancement to the high photocatalytic performance, high loading content, and good dispersion of AKCN-Fe. In addition, the photocatalytic antibacterial mechanism of the composite coating is supported by scavenger experiments and electron paramagnetic resonance (EPR) measurements, suggesting that superoxide (·O2−) and hydroxyl radical (·OH) play main and secondary roles, respectively