A prospective clinical study of a multistep screw insertion method using a patient-specific screw guide template system (SGTS) for the cervical and thoracic spine.
To evaluate the efficacy of SGTS ...for inserting screws into the cervical and thoracic spine.
Posterior screw fixation is a standard procedure for spinal instrumentation; however, screw insertion carries the risk of injury to neuronal and vascular structures.
Preoperative bone images of the computed tomography (CT) scans were analyzed using 3D/multiplanar imaging software, and the screw trajectories were planned. Plastic templates with screw-guiding structures were created for each lamina using 3D design and printing technology. Three types of templates were made for precise multistep guidance, and all the templates were specially designed to fit and lock onto the lamina during the procedure. In addition, plastic vertebra models were generated, and preoperative screw insertion simulation was performed. This patient-specific SGTS was used to perform the surgery, and CT scanning was used to postoperatively evaluate screw placement.
Enrolled to verify this procedure were 103 patients with cervical, thoracic, or cervicothoracic pathologies. The SGTS were used to place 813 screws. Preoperatively, each template was found to fit exactly and to lock onto the lamina of the vertebra models. In addition, intraoperatively, the templates fit and locked onto the patient lamina, and the screws were inserted successfully. Postoperative CT scans confirmed that 801 screws (98.5%) were accurately placed without cortical violation. There were no injuries to the vessels or nerves.
The multistep, patient-specific SGTS is useful for intraoperative pedicle screw (PS) navigation in the cervical and thoracic spine. This method improves the accuracy of PS insertion and reduces the operating time and radiation exposure during spinal fixation surgery.
3.
Objectives. Failed back surgery syndrome (FBSS) refers to a condition where symptoms such as low back pain, leg pain, and numbness persist or recur after lumbar surgery; it has been reported to occur ...in 10%–40% of patients who have undergone lumbar surgery. Spinal cord stimulation (SCS) has been reported useful for low back and leg pain due to FBSS. In this study, we studied the efficacy and safety of SCS for FBSS in older adults. Methods. Among FBSS patients who underwent an SCS trial between November 2017 and December 2020, those with at least 50% pain reduction during the trial phase who requested spinal cord stimulator implantation underwent implantation of a stimulator under local anesthesia. The patients were divided into two groups: patients aged <75 years (<75-year-old group) and patients aged ≥75 years (≥75-year-old group). The male/female ratio, symptom duration, operative duration, visual analog scale (VAS) scores before and after one year of surgery, responder rate (RR), complications one year after surgery, and stimulator removal rate were analyzed. Results. There were 27 cases in the <75-year-old group and 46 in the ≥75-year-old group, with no significant differences in male/female ratio, duration of pain, or operative time between the two groups. VAS scores for low back pain, leg pain, and overall pain one year after surgery were improved significantly from respective preoperative scores in both groups P<0.001. There were no significant differences in low back pain VAS, leg pain VAS, overall pain VAS, RR, complications one year after surgery, or stimulator removal rate between the two groups. Conclusion. SCS reduced pain effectively in both <75-year-old and ≥75-year-old groups with no differences in complications. Therefore, spinal cord stimulator implantation was considered a viable option for FBSS treatment in older adults because it can be performed under local anesthesia and is associated with a low incidence of complications.
The characteristics of 2 Glycyrrhiza plants, G. glabra and G. bucharica (=Meristotropis bucharica), were investigated in Tajikistan. The glycyrrhizin content in the underground parts of G. glabra ...varied from 2.56 to 9.29% of the dry weight, and the content of glabridin, a species-specific flavonoid of G. glabra, varied from 0.09 to 0.92% of the dry weight. Seeds of G. glabra plants from Tajikistan were cultivated for 3 years in Japan, and the glycyrrhizin content of the harvested roots ranged from 0.75 to 1.82% of the dry weight. In addition, HPLC analysis of leaf extracts indicated that the G. glabra plants collected in Tajikistan could be divided into various types, according to the flavonoid contents of the leaves. The endemic G. bucharica was also collected. A phylogenetic tree of rbcL nucleotide sequences from various Glycyrrhiza plants indicated that G. bucharica was closely related to the three glycyrrhizin-producing Glycyrrhiza spp. (G. uralensis, G. inflata, and G. glabra), even though G. bucharica does not produce glycyrrhizin.
Nitrogen-martensitic phase (Fe0.8Co0.2)8N was successfully synthesized by using an industrially suitable gas-nitriding process of a bulk foil. So far, the nitrogen-martensitic phase of the bulk ...material has not been synthesized at such a high Co content. We found that this is because the nitride was easily denitrided by elevating temperature. In this work, by exploiting a NH3 gas-nitriding process combined with quenching at a rapid cooling rate (>800 °C/s) in NH3 atmosphere, we found that nitrogen stayed at the surface layer of the foil. By using cross-sectional laser microscopy, the nitride region was observed as a 7-μm-thick layered shape at the surface of the 100-μm-thick foil. An x-ray diffraction technique revealed that the nitride layer was a martensitic phase that was characterized as a body-centered tetragonal structure with c/a = 1.04. These findings can be applied to nitriding and surface treatments for alloy systems in which a nitrogen solid solution is hardly formed. Our developed method is promising because the martensitic phase is expected to be formed in whole bulk by further optimizing parameters clarified in this work.
Abstract
Electronic instabilities in transition metal compounds often spontaneously form orbital molecules, which consist of orbital-coupled metal ions at low temperature. Recent local structural ...studies utilizing the pair distribution function revealed that preformed orbital molecules appear disordered even in the high-temperature paramagnetic phase. However, it is unclear whether preformed orbital molecules are dynamic or static. Here, we provide clear experimental evidence of the slow dynamics of disordered orbital molecules realized in the high-temperature paramagnetic phase of LiVS
2
, which exhibits vanadium trimerization upon cooling below 314 K. Unexpectedly, the preformed orbital molecules appear as a disordered zigzag chain that fluctuate in both time and space under electron irradiation. Our findings should advance studies on soft matter physics realized in an inorganic material due to disordered orbital molecules.
Two novel 112-type palladium-doped iron arsenides were synthesized and identified using comprehensive studies involving synchrotron X-ray diffraction and X-ray absorption near-edge structure (XANES) ...experiments. Whereas in-plane arsenic zigzag chains were found in the 112-type superconducting iron arsenide Ca1-xLaxFeAs2 with maximum Tc = 34 K, deformed arsenic network structures appeared in other 112-type materials, such as longitudinal arsenic zigzag chains in CaFe1-yPdyAs2 (y ∼ 0.51) and arsenic square sheets constructed via hypervalent bonding in Ca1-xLaxFe1-yPdyAs2 (x ∼ 0.31, y ∼ 0.30). As K-edge XANES spectra clarified the similar oxidization states around FeAs4 tetrahedrons, alluding to possible parents for high-Tc 112-type iron arsenide superconductors.
The crystal structure of the excitonic insulator Ta2NiSe5 has been investigated under a range of pressures, as determined by the complementary analysis of both single-crystal and powder synchrotron ...X-ray diffraction measurements. The monoclinic ambient-pressure excitonic insulator phase II transforms upon warming or under a modest pressure to give the semiconducting C-centred orthorhombic phase I. At higher pressures (i.e. >3 GPa), transformation to the primitive orthorhombic semimetal phase III occurs. This transformation from phase I to phase III is a pressure-induced first-order phase transition, which takes place through coherent sliding between weakly coupled layers. This structural phase transition is significantly influenced by Coulombic interactions in the geometric arrangement between interlayer Se ions. Furthermore, upon cooling, phase III transforms into the monoclinic phase IV, which is analogous to the excitonic insulator phase II. Finally, the excitonic interactions appear to be retained despite the observed layer sliding transition.
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