Materials in Spine Surgery

1998 ◽  
Vol 02 (02) ◽  
pp. 73-88 ◽  
Author(s):  
Vijay K. Goel ◽  
Erik O. Martz ◽  
Joon B. Park
Keyword(s):  
Success Rate ◽  
Spine Surgery ◽  
Surgical Procedures ◽  
Spinal Surgery ◽  
Patient Comfort ◽  
Wide Range ◽  
Technical Innovations ◽  
Materials Used ◽  
Spinal Function

A wide variety of surgical procedures ranging from laminectomy to vertebral body resection are used to restore spinal function. Accordingly, a wide range of man-made and natural materials are used as supplements to improve the long term success rate of these procedures and patient comfort. Requirements for the materials used in spine surgery are similar to other applications; tissue compatibility in terms of mechanical, chemical and pharmacological requirements. The requirements may change as the tissue heals with time. It is imperative that the materials be "dynamic" in their abilities to respond to the changing environmental needs. Due to technical innovations in the area of biomaterials, newer materials have been proposed for the spinal surgery. Graft materials (fat, allo-, auto, BMP), metals, polymers, ceramics, and composites are used to restore spinal function.

A comparison of partial inferior turbinectomy and cryosurgery for hypertrophic inferior turbinates

1996 ◽  
Vol 110 (8) ◽  
pp. 732-735 ◽  
Author(s):  
Yoseph Rakover ◽  
Gabriel Rosen
Keyword(s):  
Success Rate ◽  
Surgical Procedures ◽  
Postoperative Morbidity ◽  
Simple Procedure ◽  
Functional Results ◽  
Effective Therapy ◽  
Outpatient Basis ◽  
One Year

AbstractA variety of surgical procedures are performed for treatment of hypertrophic inferior turbinates, but there is no completely effective therapy. We evaluated subjectively and objectively 52 patients who underwent one of two procedures: partial inferior turbinectomy (PIT) or cryosurgery of the inferior turbinates (CS). The results of PIT showed good functional results in 77 per cent of cases for long-term effectiveness. The results of CS showed that effectiveness was reduced from a 62 per cent success rate after one year to 35 per cent later, but CS was a simple procedure which was performed on an outpatient basis with no postoperative morbidity.

Toxicocinetic and Mechanisms of Action of Nanoparticles

2019 ◽  
pp. 344-368
Author(s):  
Abderrezak Khelfi
Keyword(s):  
Human Exposure ◽  
Engineered Nanoparticles ◽  
Membrane Structures ◽  
Inflammatory Reactions ◽  
Long Term Effect ◽  
Wide Range ◽  
Short And Long Term ◽  
Materials Used ◽  
Cell Signaling Pathways

Human exposure to nanoparticles has been dramatically increased in the past 25 years as a result of the rapidly developing field of nanotechnology. Many have recognized the importance of identifying potential effects on human health associated with the manufacture and use of these important technology. Many questions remain unanswered regarding the short- and long-term effect, systemic toxicity, and carcinogenicity. Engineered nanoparticles can be taken up by the human body via inhalation, ingestion, dermal uptake, and injection. They can reach the bloodstream and ultimately affect multiple body organs such as liver and spleen or even transcend the blood-brain barrier. Because of the huge diversity of materials used and the wide range in size of nanoparticles, these effects will vary a lot. Local and systemic adverse effects consist of primarily inflammatory reactions. Other observed effects include generation of reactive oxygen species and subsequent oxidative stress, disruption of proteins, DNA, mitochondria and membrane structures, as well as changes in cell signaling pathways.

Toxicocinetic and Mechanisms of Action of Nanoparticles

2021 ◽  
pp. 1572-1596
Author(s):  
Abderrezak Khelfi
Keyword(s):  
Human Exposure ◽  
Engineered Nanoparticles ◽  
Membrane Structures ◽  
Inflammatory Reactions ◽  
Long Term Effect ◽  
Wide Range ◽  
Short And Long Term ◽  
Materials Used ◽  
Cell Signaling Pathways

Human exposure to nanoparticles has been dramatically increased in the past 25 years as a result of the rapidly developing field of nanotechnology. Many have recognized the importance of identifying potential effects on human health associated with the manufacture and use of these important technology. Many questions remain unanswered regarding the short- and long-term effect, systemic toxicity, and carcinogenicity. Engineered nanoparticles can be taken up by the human body via inhalation, ingestion, dermal uptake, and injection. They can reach the bloodstream and ultimately affect multiple body organs such as liver and spleen or even transcend the blood-brain barrier. Because of the huge diversity of materials used and the wide range in size of nanoparticles, these effects will vary a lot. Local and systemic adverse effects consist of primarily inflammatory reactions. Other observed effects include generation of reactive oxygen species and subsequent oxidative stress, disruption of proteins, DNA, mitochondria and membrane structures, as well as changes in cell signaling pathways.

scholarly journals The Technological Development of Minimally Invasive Spine Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Laura A. Snyder ◽  
John O'Toole ◽  
Kurt M. Eichholz ◽  
Mick J. Perez-Cruet ◽  
Richard Fessler
Keyword(s):  
Minimally Invasive ◽  
Spine Surgery ◽  
Spinal Surgery ◽  
Technological Development ◽  
Case Reports ◽  
Minimally Invasive Spine Surgery ◽  
Large Field ◽  
The Past ◽  
Wide Range ◽  
Minimally Invasive Spine

Minimally invasive spine surgery has its roots in the mid-twentieth century with a few surgeons and a few techniques, but it has now developed into a large field of progressive spinal surgery. A wide range of techniques are now called “minimally invasive,” and case reports are submitted constantly with new “minimally invasive” approaches to spinal pathology. As minimally invasive spine surgery has become more mainstream over the past ten years, in this paper we discuss its history and development.

European Experience with a System for Bifurcated Stent-Graft Insertion

1997 ◽  
Vol 4 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Timothy A.M. Chuter ◽  
George Wendt ◽  
Brian R. Hopkinson ◽  
R. Alan P. Scott ◽  
Bo Risberg ◽  
...  
Keyword(s):  
Success Rate ◽  
Stent Migration ◽  
Graft Thrombosis ◽  
European Experience ◽  
Wide Range ◽  
The Difference ◽  
Procedural Success ◽  
Current Selection

Purpose: To test an endovascular aneurysm exclusion system in the presence of a wide range of challenging anatomic features. Methods: Bifurcated endovascular stent-grafts were inserted in 52 patients and followed with serial computed tomography for up to 3 years. The device underwent several modifications during this time, the most significant of which represent the difference between the homemade (n = 42) and industry-made (n = 10) versions. Results: The initial procedural success rate was 92% in the homemade group and 100% in the industry-made group. In the 3 years of follow-up, the long-term success rate was 64% in the homemade group and 90% in the industry-made group. The primary reasons for failure in the homemade group were graft thrombosis due to kinking early in the series and proximal stent migration later in our experience. All cases of migration occurred when the neck was < 15 mm in length, the neck was lined with thrombus, or the stent was implanted > 15 mm from the renal arteries. Kinking was subsequently overcome by implanting Wallstents throughout the graft limbs. The sole failure in the industry-made group was a case in which collateral perfusion reached the aneurysm through patent lumbar arteries. Conclusions: The fruits of this experience are a better technique, a better device, and, most importantly, a better understanding of the system's limits, as reflected in the current selection criteria.

scholarly journals Relevance of Modified Debridement-Irrigation, Antibiotic Therapy and Implant Retention Protocol for the Management of Surgical Site Infections: A Series of 1694 Instrumented Spinal Surgery

2018 ◽  
Vol 3 (5) ◽  
pp. 266-272 ◽  
Author(s):  
Romain Manet ◽  
Tristan Ferry ◽  
Jean-Etienne Castelain ◽  
Gilda Pardey Bracho ◽  
Eurico Freitas-Olim ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Antibiotic Therapy ◽  
Success Rate ◽  
Surgical Procedures ◽  
Spinal Surgery ◽  
Surgical Site Infections ◽  
Second Look ◽  
Implant Retention ◽  
New Surgery

Abstract. Introduction: Management of surgical site infections (SSI) after instrumented spinal surgery remains controversial. The debridement-irrigation, antibiotic therapy and implant retention protocol (DAIR protocol) is safe and effective to treat deep SSI occurring within the 3 months after instrumented spinal surgery.Methods: This retrospective study describes the outcomes of patients treated over a period of 42 months for deep SSI after instrumented spinal surgery according to a modified DAIR protocol.Results: Among 1694 instrumented surgical procedures, deep SSI occurred in 46 patients (2.7%): 41 patients (89%) experienced early SSI (< 1 month), 3 (7%) delayed SSI (from 1 to 3 months), and 2 (4%) late SSI (> 3months). A total of 37 patients had a minimum 1 year of follow-up; among these the modified DAIR protocol was effective in 28 patients (76%) and failed (need for new surgery for persistent signs of SSI beyond 7 days) in 9 patients (24%). Early second-look surgery (≤ 7days) for iterative debridement was performed in 3 patients, who were included in the cured group. Among the 9 patients in whom the modified DAIR protocol failed, none had early second-look surgery; 3 (33%) recovered and were cured at 1 year follow-up, and 6 (66%) relapsed. Overall, among patients with SSI and a minimum 1 year follow-up, the modified DAIR protocol led to healing in 31/37 (84%) patients.Conclusions: The present study supports the effectiveness of a modified DAIR protocol in deep SSI occurring within the 3 months after instrumented spinal surgery. An early second-look surgery for iterative debridement could increase the success rate of this treatment.

scholarly journals Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

2020 ◽  
Author(s):  
Tetsuro Ohba ◽  
Hiroshi MD Yokomi ◽  
Kensuke MD Koy ◽  
Nobuki Tanaka ◽  
Kotaro Oda ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Surgical Procedures ◽  
Vertebral Fractures ◽  
Spinal Surgery ◽  
Postoperative Mortality ◽  
Term Survival ◽  
Kaplan Meier ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. Our aim was to evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality. Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Mortality was estimated using the Kaplan-Meier method and a log-rank test. The preoperative backgrounds of patients were analyzed to determine which risk factors led to death among the OVF cases. Kaplan-Meier curves were used to estimate survival based on preoperative albumin levels of £ 3.5 g/dL (hypoalbuminemia) versus > 3.5 mg/dL. Results: The mean follow-up time for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin £3.5 g/dL was a significant risk factor for long-term postoperative mortality of patients with OVF. Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.

scholarly journals Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

2019 ◽  
Author(s):  
Tetsuro Ohba ◽  
Hiroshi MD Yokomi ◽  
Kensuke MD Koy ◽  
Nobuki Tanaka ◽  
Kotaro Oda ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Surgical Procedures ◽  
Vertebral Fractures ◽  
Spinal Surgery ◽  
Postoperative Mortality ◽  
Term Survival ◽  
Kaplan Meier ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. To evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality. Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Morbidity was estimated using the Kaplan-Meier method and a log-rank test. To determine which risk factors led to death among the OVF cases, the preoperative backgrounds of patients were analyzed. Kaplan-Meier curves were used to estimate survival based on the preoperative albumin levels of ≤3.5 g/dL (hypoalbuminemia) versus >3.5 mg/dL. Results: The mean follow-up for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin ≤3.5 g/dL was a significant risk factor for long-term postoperative mortality of people with OVF. Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.

scholarly journals Mineral Trioxide Aggregate Versus Calcium Hydroxide in Direct Pulp Capping: A Review of Literature

2020 ◽  
Vol 5 (07) ◽  
Author(s):  
Abdullah Mohammed Alrabiah
Keyword(s):  
Success Rate ◽  
Calcium Hydroxide ◽  
Mineral Trioxide Aggregate ◽  
Cost Effective ◽  
Long Term Results ◽  
Glass Ionomer ◽  
Direct Pulp Capping ◽  
Pulp Capping ◽  
Materials Used

Direct pulp-capping is a treatment for exposed vital pulp involving the placement of a dental material over the exposed area. This facilitates both the formation of protective barrier and the maintenance of vital pulp. Direct pulp capping (DPC) has been used as an alternative approach to the maintenance of vital pulp. So, many tooth extractions and root canal treatments could have been avoided through the conservative approach of direct pulp capping. For this purpose, different kinds of materials used such as Zinc Oxide Eugenol, Glass Ionomer (GI), Resin Modified Glass Ionomer (RMGI), Adhesive systems, Calcium Hydroxide (CH), Mineral Trioxide Aggregate (MTA) and Bio dentine. MTA performed more effective than conventional Calcium Hydroxide clinically as a direct pulp capping material. MTA showed higher success rate than dycal. MTA is easier to use clinically as a direct pulp capping material. MTA also provided better long-term results and more effective than Calcium Hydroxide in maintaining long-term vitality. MAT is significantly less toxic, less pulpal inflammations. Furthermore, MTA is more predictable than dycal in formation of dentin barrier and superior than Calcium Hydroxide in dentinogenetic process in human pulp. MTA is more effective and superior comparing the Calcium Hydroxide as a direct pulp capping material, demonstrating higher success rate with favorable outcomes in maintaining long term tooth vitality and easier to use in pulp capping. Finally, MTA is more cost-effective than CH for DPC despite higher initial treatment costs because expensive retreatments were avoided.

scholarly journals Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality

2020 ◽  
Author(s):  
Tetsuro Ohba ◽  
Hiroshi MD Yokomi ◽  
Kensuke MD Koy ◽  
Nobuki Tanaka ◽  
Kotaro Oda ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Surgical Procedures ◽  
Vertebral Fractures ◽  
Spinal Surgery ◽  
Postoperative Mortality ◽  
Term Survival ◽  
Kaplan Meier ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Abstract Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. Our aim was to evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality.Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Mortality was estimated using the Kaplan-Meier method and a log-rank test. The preoperative backgrounds of patients were analyzed to determine which risk factors led to death among the OVF cases. Kaplan-Meier curves were used to estimate survival based on preoperative albumin levels of £ 3.5 g/dL (hypoalbuminemia) versus > 3.5 mg/dL.Results: The mean follow-up time for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin £3.5 g/dL was a significant risk factor for long-term postoperative mortality of patients with OVF.Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.Level of Evidence: Level 3

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