scholarly journals A Simple and Effective Technique for Removing Broken Pedicle Screws

2021 ◽  
Author(s):  
Qian-xing Deng ◽  
Rong Zhang ◽  
Jian-quan Yu ◽  
Yong Tao ◽  
Peng Zhan ◽  
...  
Keyword(s):  
High Speed ◽  
Pedicle Screws ◽  
Low Back ◽  
Spinal Segment ◽  
Nerve Roots ◽  
Effective Technique ◽  
Secondary Surgery ◽  
Institutional Review ◽  
Cord Injury ◽  
The Mean

Abstract Background: Different methods and tools had been developed to remove the broken pedicle screws. Removing a broken pedicle screws was not always easy. We reported a simple and effective technique to remove the broken pedicle screws in this study.Methods: The Institutional Review Board of the Fengdu people's Hospital of Chongqing approved the study. A total of 34 patients (aged 47.76±8.12 years) accepted first operation because of thoracolumbar fractures in our department and other departments were analyzed retrospectively. They accepted secondary surgery to remove the spinal instrumentations when they obtained bone fusion or bone healing from March 2017 to March 2020. We applied a high speed drill (with 2mm diameter), a three rhomboid pointed cone, an acutenaculum, and a larger forceps to remove the broken pedicle screws.Results: The spinal segment of broken pedicle screws was consist of L2 (3 cases), L3 (8 cases), L4 (17 cases), L5 (6 cases). The location of the broken pedicle screws was within the scope of pedicle. There were no complications about broken pedicle screws, such as injury of nerve roots, severe low back pain, and spinal cord injury. The average time of removing the broken pedicle screws was 13.79±3.52 minutes. The mean blood loss of surgery was 72.06±28.05 milliliters. No other complications happened during surgery.Conclusion: A simple and effective technique for removing broken pedicle screws is reported. This technique reserves the original nail road of pedicle, does not destroy the pedicle cortex, and averts producing the debris of spinal instrumentations.

Articulatory Behavior Pre and Post Full-Mouth Tooth Extraction and Alveoloplasty

1980 ◽  
Vol 23 (3) ◽  
pp. 630-645 ◽  
Author(s):  
Gerald Zimmermann ◽  
J.A. Scott Kelso ◽  
Larry Lander
Keyword(s):  
Control Subject ◽  
High Speed ◽  
Tooth Extraction ◽  
Kinematic Parameters ◽  
Experimental Conditions ◽  
Mean Values ◽  
Articulatory Movements ◽  
The Mean ◽  
Experimental Subjects ◽  
Normal Speech

High speed cinefluorography was used to track articulatory movements preceding and following full-mouth tooth extraction and alveoloplasty in two subjects. Films also were made of a control subject on two separate days. The purpose of the study was to determine the effects of dramatically altering the structural dimensions of the oral cavity on the kinematic parameters of speech. The results showed that the experimental subjects performed differently pre and postoperatively though the changes were in different directions for the two subjects. Differences in both means and variabilities of kinematic parameters were larger between days for the experimental (operated) subjects than for the control subject. The results for the Control subject also showed significant differences in the mean values of kinematic variables between days though these day-to-day differences could not account for the effects found pre- and postoperatively. The results of the kinematic analysis, particularly the finding that transition time was most stable over the experimental conditions for the operated subjects, are used to speculate about the coordination of normal speech.

Delayed Treatment of Spinal Cord Injury In Young: A Case Report

2018 ◽  
Vol 1 (2) ◽  
pp. 15
Author(s):  
Joshua Sutikno
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Traffic Accidents ◽  
Epidemiological Data ◽  
Morbidity Rate ◽  
High Morbidity ◽  
Low Back ◽  
Traditional Treatment ◽  
Delayed Treatment ◽  
Cord Injury

Background: Spinal cord injury (SCI), one of the problems caused by traffic accidents, has a high morbidity in developing country like Indonesia. In Indonesia, the use of motorcycles is increasing every year. The epidemiological data from Fatmawati Hospital of spinal cord injury in 2014 was 104 cases both traumatic and non-traumatic SCI. In this case, a young boy with worsening of SCI, delayed the treatment for about 3 months.Case: A 19 years-old male complained of limbs paralysis for the past two weeks. He felt numbness and tingling in hamstring and calf areas. From past medical history, he had a motorcycle accident 3 months prior. After the accident, he suffered from extreme low back pain, but he could still move his legs. Due to economic restrictions, the patient refused to go to the hospital, and they chose a traditional treatment. For about three months, the pain was decreasing, but he was never pain-free. As the symptoms continued to worsen, the neurosurgeon decided to decompress the spinal cord and performed discectomy. After a week of treatment, the pain disappeared, motor muscle got better, and he could feel again the sensation on the dermatome of S1. Conclusion: Early treatment is recommended to get a better outcome. The surgery is not the only treatment, rehabilitation and orthotics using are important too. Delayed treatment increases morbidity rate.

scholarly journals The influence of solar wind on extratropical cyclones – Part 1: Wilcox effect revisited

2009 ◽  
Vol 27 (1) ◽  
pp. 1-30 ◽  
Author(s):  
P. Prikryl ◽  
V. Rušin ◽  
M. Rybanský
Keyword(s):  
Time Series ◽  
Solar Wind ◽  
Northern Hemisphere ◽  
High Speed ◽  
Coronal Holes ◽  
Extratropical Cyclones ◽  
Sector Boundary ◽  
Speed Solar Wind ◽  
The Mean ◽  
High Speed Solar Wind

Abstract. A sun-weather correlation, namely the link between solar magnetic sector boundary passage (SBP) by the Earth and upper-level tropospheric vorticity area index (VAI), that was found by Wilcox et al. (1974) and shown to be statistically significant by Hines and Halevy (1977) is revisited. A minimum in the VAI one day after SBP followed by an increase a few days later was observed. Using the ECMWF ERA-40 re-analysis dataset for the original period from 1963 to 1973 and extending it to 2002, we have verified what has become known as the "Wilcox effect" for the Northern as well as the Southern Hemisphere winters. The effect persists through years of high and low volcanic aerosol loading except for the Northern Hemisphere at 500 mb, when the VAI minimum is weak during the low aerosol years after 1973, particularly for sector boundaries associated with south-to-north reversals of the interplanetary magnetic field (IMF) BZ component. The "disappearance" of the Wilcox effect was found previously by Tinsley et al. (1994) who suggested that enhanced stratospheric volcanic aerosols and changes in air-earth current density are necessary conditions for the effect. The present results indicate that the Wilcox effect does not require high aerosol loading to be detected. The results are corroborated by a correlation with coronal holes where the fast solar wind originates. Ground-based measurements of the green coronal emission line (Fe XIV, 530.3 nm) are used in the superposed epoch analysis keyed by the times of sector boundary passage to show a one-to-one correspondence between the mean VAI variations and coronal holes. The VAI is modulated by high-speed solar wind streams with a delay of 1–2 days. The Fourier spectra of VAI time series show peaks at periods similar to those found in the solar corona and solar wind time series. In the modulation of VAI by solar wind the IMF BZ seems to control the phase of the Wilcox effect and the depth of the VAI minimum. The mean VAI response to SBP associated with the north-to-south reversal of BZ is leading by up to 2 days the mean VAI response to SBP associated with the south-to-north reversal of BZ. For the latter, less geoeffective events, the VAI minimum deepens (with the above exception of the Northern Hemisphere low-aerosol 500-mb VAI) and the VAI maximum is delayed. The phase shift between the mean VAI responses obtained for these two subsets of SBP events may explain the reduced amplitude of the overall Wilcox effect. In a companion paper, Prikryl et al. (2009) propose a new mechanism to explain the Wilcox effect, namely that solar-wind-generated auroral atmospheric gravity waves (AGWs) influence the growth of extratropical cyclones. It is also observed that severe extratropical storms, explosive cyclogenesis and significant sea level pressure deepenings of extratropical storms tend to occur within a few days of the arrival of high-speed solar wind. These observations are discussed in the context of the proposed AGW mechanism as well as the previously suggested atmospheric electrical current (AEC) model (Tinsley et al., 1994), which requires the presence of stratospheric aerosols for a significant (Wilcox) effect.

scholarly journals Modeling the Excess Velocity of Low-Viscous Taylor Droplets in Square Microchannels

Fluids ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 162 ◽  
Author(s):  
Thorben Helmers ◽  
Philip Kemper ◽  
Jorg Thöming ◽  
Ulrich Mießner
Keyword(s):  
High Speed ◽  
Process Intensification ◽  
Continuous Phase ◽  
Channel Cross Section ◽  
Optimization Approach ◽  
Mean Flow ◽  
Bypass Flow ◽  
Wall Film ◽  
Proposed Model ◽  
The Mean

Microscopic multiphase flows have gained broad interest due to their capability to transfer processes into new operational windows and achieving significant process intensification. However, the hydrodynamic behavior of Taylor droplets is not yet entirely understood. In this work, we introduce a model to determine the excess velocity of Taylor droplets in square microchannels. This velocity difference between the droplet and the total superficial velocity of the flow has a direct influence on the droplet residence time and is linked to the pressure drop. Since the droplet does not occupy the entire channel cross-section, it enables the continuous phase to bypass the droplet through the corners. A consideration of the continuity equation generally relates the excess velocity to the mean flow velocity. We base the quantification of the bypass flow on a correlation for the droplet cap deformation from its static shape. The cap deformation reveals the forces of the flowing liquids exerted onto the interface and allows estimating the local driving pressure gradient for the bypass flow. The characterizing parameters are identified as the bypass length, the wall film thickness, the viscosity ratio between both phases and the C a number. The proposed model is adapted with a stochastic, metaheuristic optimization approach based on genetic algorithms. In addition, our model was successfully verified with high-speed camera measurements and published empirical data.

scholarly journals Electrical stimulator with mechanomyography-based real-time monitoring, muscle fatigue detection, and safety shut-off: a pilot study

2020 ◽  
Vol 65 (4) ◽  
pp. 461-468
Author(s):  
Jannatul Naeem ◽  
Nur Azah Hamzaid ◽  
Amelia Wong Azman ◽  
Manfred Bijak
Keyword(s):  
Muscle Fatigue ◽  
Real Time ◽  
Isometric Force ◽  
Mean Square ◽  
Clear Indication ◽  
Initial Value ◽  
Cord Injury ◽  
The Mean ◽  
Electrical Stimulator ◽  
Fatigue Detection

AbstractFunctional electrical stimulation (FES) has been used to produce force-related activities on the paralyzed muscle among spinal cord injury (SCI) individuals. Early muscle fatigue is an issue in all FES applications. If not properly monitored, overstimulation can occur, which can lead to muscle damage. A real-time mechanomyography (MMG)-based FES system was implemented on the quadriceps muscles of three individuals with SCI to generate an isometric force on both legs. Three threshold drop levels of MMG-root mean square (MMG-RMS) feature (thr50, thr60, and thr70; representing 50%, 60%, and 70% drop from initial MMG-RMS values, respectively) were used to terminate the stimulation session. The mean stimulation time increased when the MMG-RMS drop threshold increased (thr50: 22.7 s, thr60: 25.7 s, and thr70: 27.3 s), indicating longer sessions when lower performance drop was allowed. Moreover, at thr70, the torque dropped below 50% from the initial value in 14 trials, more than at thr50 and thr60. This is a clear indication of muscle fatigue detection using the MMG-RMS value. The stimulation time at thr70 was significantly longer (p = 0.013) than that at thr50. The results demonstrated that a real-time MMG-based FES monitoring system has the potential to prevent the onset of critical muscle fatigue in individuals with SCI in prolonged FES sessions.

60 Contact Hand Burns in Children: Still a Major Prevention Need

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S39-S40
Author(s):  
Jaclyn M McBride ◽  
Kathleen S Romanowski ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
David G Greenhalgh
Keyword(s):  
Graft Loss ◽  
Dorsal Surface ◽  
Skin Grafting ◽  
Secondary Surgery ◽  
Surface Areas ◽  
Palmar Surface ◽  
The Mean ◽  
Total Body ◽  
Hand Burns ◽  
Palmar Aspect

Abstract Introduction Since toddlers explore with their hands, contact burns continue to be a major pediatric problem. The purpose of this report is to review a pediatric burn unit’s 8-year experience with contact burns of the hand. Methods After IRB approval, a review of pediatric contact hand burns that occurred between 2006–2014 was performed. We examined the causes and outcomes in pediatric contact hand burns in a single pediatric burn program. Results In the 8-year span, 535 children suffered contact burns to the hand (67 per year). The majority suffered hands burns from an oven or stove (120). The other etiologies included burns from a fireplace (76), clothing iron (65), curling or straightening iron (50), and firepit or campfire (46). The mean age at time of injury was 2.62 years old, with a range of 2 months old to18 years old. Male children (339) typically burned their hands more than females (197). Locations of injury included the palmar surface, dorsal surface, fingers tips/thumb, wrist or a combination of several different areas. Most children burned the palmar aspect of their hand (384) compared to the dorsal aspect (61). These burns typically cover small total body surface areas (mean 1.08% TBSA), with only 2% of burns comprising >5% TBSA. Approximately, 84% of these patients did not need surgery, but 86 (16%) had skin grafting (usually full-thickness) and 26% needed a secondary surgery. Of those that needed more than two, the average number of procedures was 3.6. Approximately 4.1% of patients needed a tertiary surgery. Causes for tertiary surgeries included contractures and graft loss. Out of twenty-two patients that needed a third surgery, 59% were due to graft loss and 41% were due to contractures. Conclusions Contact burns to the hand continue to be a major problem for toddlers. Children are most likely to burn themselves on an oven or stove, fireplace, clothing iron or curling/straightening iron. The palmar surface of the hand is the most likely site. While most children do not require surgery, approximately 16% require grafting. A significant number of those patients need reconstructive surgery. Clearly, current prevention efforts have failed to reduce these injuries. Applicability of Research to Practice Palm burns are common in young children. Efforts should focus on preventing these injuries.

Urinary Excretion of Hydroxyproline after Fractures

1970 ◽  
Vol 16 (10) ◽  
pp. 853-855
Author(s):  
Mala Herzberg ◽  
Z Oberman ◽  
O Khermosh ◽  
S L Weissman
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Urinary Excretion ◽  
Collagen Metabolism ◽  
Bone Collagen ◽  
Control Group ◽  
Low Back ◽  
Multiple Fractures ◽  
Daily Excretion ◽  
The Mean

Abstract Urinary excretion of hydroxyproline was measured in 12 cases of multiple fractures as an index of bone collagen metabolism. Measurements were made for 10 consecutive days after injury; 10 patients with low back pain served as the control group. With three exceptions, the mean daily excretion of hydroxyproline and the day-to-day variations were within the same range in the group with multiple fractures as in the control group.

Retroclival Epidural Hematomas

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 404-407 ◽  
Author(s):  
R. Shane Tubbs ◽  
Christoph J. Griessenauer ◽  
Todd Hankinson ◽  
Curtis Rozzelle ◽  
John C. Wellons ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Pediatric Patients ◽  
Motor Vehicle ◽  
Coma Scale ◽  
Presenting Symptoms ◽  
Cord Injury ◽  
The Mean

Abstract BACKGROUND Retroclival epidural hematomas (REDHs) are infrequently reported. To our knowledge, only 19 case reports exist in the literature. OBJECTIVE This study was performed to better elucidate this pathology. METHODS We prospectively collected data for all pediatric patients diagnosed with REDH from July 2006 through June 2009. Data included mechanism of injury, Glasgow Coma Scale score, neurological examination, treatment modality, and outcome. Magnetic resonance imaging was used to measure REDH dimensions. RESULTS Eight children were diagnosed with REDH, and the hematomas were secondary to motor vehicle–related trauma in all cases. The mean age of patients was 12 years (range 4–17 years). The mean REDH height (craniocaudal) was 4.0 cm, and the mean thickness (dorsoventral) was 1.0 cm. At presentation, the mean Glasgow Coma Scale score was 8 (range 3–14), and there was no correlation between hematoma size and presenting symptoms. Two patients died soon after injury, and 2 additional patients had atlanto-occipital dislocation that required surgical intervention. No patient underwent surgical evacuation of the REDH. The mean follow-up was 14 months. At most recent follow-up, 4 patients are neurologically intact, 1 patient has a complete spinal cord injury, and 1 patient has mild bilateral abducens nerve palsy. CONCLUSION To our knowledge, this study of 8 pediatric patients is the largest series of patients with REDH thus far reported. Based on our study, we found that REDH is likely to be underdiagnosed, atlanto-occipital dislocation should be considered in all cases of REDH, and many patients with REDH will have minimal long-term neurological injury.

scholarly journals Posterior and Anterior Spinal Fusion for the Management of Deformities in Patients with Parkinson's Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Masashi Sato ◽  
Takeshi Sainoh ◽  
Sumihisa Orita ◽  
Kazuyo Yamauchi ◽  
Yasuchika Aoki ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Low Back Pain ◽  
Back Pain ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Anterior Fusion ◽  
Low Back ◽  
Surgical Methods ◽  
Correction Surgery

Introduction. Spinal scoliosis and kyphosis in elderly people sometimes cause severe low back pain. Surgical methods such as osteotomy are useful for correcting the deformity. However, complications during and after surgery are associated with the osteotomy procedure. In particular, it is difficult to manage deformity correction surgery for patients with Parkinson's disease. Here, we present two cases of combined anterior and posterior surgery for deformity in patients with adult scoliosis and kyphosis due to Parkinson's disease.Case Presentation. Two 70-year-old women had spinal scoliosis and kyphosis due to Parkinson's disease. They had severe low back pain, and conservative treatment was not effective for the pain. Surgery was planned to correct the deformity in both patients. We performed combined posterior and anterior correction surgery. At first, posterior fusions were performed from T4 to the ilium using pedicle screws. Next, cages and autograft from the iliac crest were used in anterior lumbar surgery. The patients became symptom free after surgery. Bony fusion was observed 12 months after surgery.Conclusions. Combined posterior and anterior fusion surgery is effective for patients who show scoliosis and kyphosis deformity, and symptomatic low back pain due to Parkinson's disease.

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