Spinal nerve segmentation method and dataset construction in endoscopic surgical scenarios

Endoscopic surgery is currently an important treatment method in the field of spinal surgery and avoiding damage to the spinal nerves through video guidance is a key challenge. This paper presents the first real-time segmentation method for spinal nerves in endoscopic surgery, which provides crucial navigational information for surgeons. A finely annotated segmentation dataset of approximately 10,000 consec-utive frames recorded during surgery is constructed for the first time for this field, addressing the problem of semantic segmentation. Based on this dataset, we propose FUnet (Frame-Unet), which achieves state-of-the-art performance by utilizing inter-frame information and self-attention mechanisms. We also conduct extended exper-iments on a similar polyp endoscopy video dataset and show that the model has good generalization ability with advantageous performance. The dataset and code of this work are presented at: https://github.com/zzzzzzpc/FUnet .Comment: Accepted by MICCAI 202

Efficacy of Wallis interspinous dynamic stabilization implant in the treatment of primary lumbar disc herniation: A prospective randomised controlled trial

Purpose:To investigate the efficacy of Wallis implant after lumbar discectomy compared with discectomy alone for patients with primary lumbar disc herniation.Methods: A total of 77 patients with primary lumbar disc herniation were randomly assigned to receive posterior lumbar discectomy combined with (n =40, Wallis group) or without (n =37, control group) Wallis implantation. The primary outcomes were Visual Analogue Scale (VAS), Japanese Orthopedics Association (JOA) score and Oswestry Disability Index (ODI). The secondary outcomes were intervertebral disc height (DH), range of motion (ROM) of operated segments, complications and the time of surgery.Results: No significant difference was found between the two groups for the VAS, JOA and ODI scores at 1 week after treatment (P>0.05). Wallis group had better scores than that for control group at 12 months (P<0.05) and last follow-up time (P<0.05). Wallis group had higher DH than that for the control group at each follow-up moment (P<0.001).Conclusion: Combination treatment may provide benefits comparable to lumbar discectomy alone for patients with lumbar disc herniation by restoring the intervertebral disc height and preserving limited motion of the spine

Incorporation of Mg-phenolic networks as a protective coating for magnesium alloy to enhance corrosion resistance and osteogenesis in vivo

Magnesium (Mg) and its alloys have been intensively studied to develop the next generation of bone implants recently, but their clinical application is restricted by rapid degradation and unsatisfied osteogenic effect in vivo. A bioactive chemical conversion Mg-phenolic networks complex coating (eEGCG) was stepwise incorporated by epigallocatechin-3-gallate (EGCG) and exogenous Mg2+ on Mg-2Zn magnesium alloy. Simplex EGCG induced chemical conversion coating (cEGCG) was set as compare group. The in vitro corrosion behavior of Mg-2Zn alloy, cEGCG and eEGCG was evaluated in SBF using electrochemical (PDP, EIS) and immersion test. The cytocompatibility was investigated with rat bone marrow mesenchymal stem cells (rBMSCs). Furthermore, the in vivo tests using a rabbit model involved micro computed tomography (Micro-CT) analysis, histological observation, and interface analysis. The results showed that the eEGCG is Mg-phenolic multilayer coating incorporated Mg-phenolic networks, which is rougher, more compact and much thicker than cEGCG. The eEGCG highly improved the corrosion resistance of Mg-2Zn alloy, combined with its lower average hemolytic ratios, continuous high scavenging effect ability and relatively moderate contact angle features, resulting in a stable and suitable biological environment, obviously promoted rBMSCs adhesion and proliferation. More importantly, Micro-CT, histological and interface elements distribution evaluations all revealed that the eEGCG effectively inhibited degradation and enhanced bone tissue formation of Mg alloy implants. This study puts forward a promising bioactive chemical conversion coating with Mg-phenolic networks for the application of biodegradable orthopedic implants

The role of melatonergic system in intervertebral disc degeneration and its association with low back pain: a clinical study

Objective The mechanisms of intervertebral disc degeneration (IVDD) in low back pain (LBP) patients are multiples. In this study, we attempt to investigate whether melatonergic system plays a potential role in IVDD patients with LBP by analyzing their clinical specimens. The fucus will be given to the correlation between the melatonin receptor expression and intervertebral disc tissue apoptosis. Methods In this clinical study, 107 lumbar intervertebral disc nucleus pulposus (NP) specimens from patients with LBP were collected with patients’ consents. The disc height (DH) discrepancy ratio, range of motion and sagittal parameters of the pathological plane were measured and Pfirrmann grade was used to classified the grades of IVDD level. Discs at grades 1–3 were served as normal control and grades 4–5 were considered as IVDD. The expression levels of melatonin receptor 1A (MT1) and 1B (MT2) were measured by immunohistochemistry. The apoptosis of NP was assessed using TUNEL staining. Their potential associations among MT1/2, DH, apoptosis, sagittal parameters with IVDD and LBP were evaluated with statistical analysis. Results The incidence of IVDD was positively associated with age and negatively related to VAS scores for LBP (p < 0.001). Patients with higher degree of IVDD also have higher DH discrepancy ratio (p < 0.001), higher prevalence of lumbar instability (p = 0.003) and higher cell apoptosis compared to the control. Nevertheless, no statistically significant correlation was identified between Pfirrmann grade and lumbar sagittal parameters. MT1 and MT2 both were highly expressed in the NP tissues. Importantly, MT1 expression but not MT2 was significantly increased in the intervertebral disc tissue of patients with IVDD and its level correlated well with cell apoptosis level and the severity of IVDD as well as lower VAS scores for LBP. Conclusion The highly elevated MT1 expression was found in NP tissues of patients with IVDD and LBP compared to the control. This phenomenon probably reflects the compensating response of the body to the pathological alteration of the IVDD and LBP. Therefore, these findings provide the novel information to use selective agonists of MT1 to target IVDD and LBP clinically