scholarly journals Intermediate Screw pada Unstable Thoracolumbar Fracture: Case Series dan Review Article

2018 ◽  
Vol 7 (3) ◽  
pp. 387
Author(s):  
Komang Agung Irianto ◽  
Dionisius Bramta Putra
Keyword(s):  
Pedicle Screw ◽  
Burst Fracture ◽  
Case Series ◽  
Cochrane Library ◽  
Correction Loss ◽  
Short Segment ◽  
Level 3 ◽  
Level 1 ◽  
Short Segment Fixation ◽  
Level 2

Area thorakolumbar merupakan hampir 90% dari semua spinal injuries dan 10% dari cedera tersebut merupakan burst fracture yang membutuhkan intervensi operatif. Terapi burst fracture thorakolumbar meliputi restorasi dari alignment, stabilisasi spinal, koreksi kifotik, dan dekompresi spinal kanal. Pertimbangan penggunaan intermediate screw masih menjadi topik perdebatan. Penambahan intermediate pedicle screw dipercaya dapat menambah stabilitas dan membantu koreksi kifosis pada long segment, short segment fixation. Penelitian ini merupakan systematic literature review. Pencarian literatur menggunakan mesin pencari elektronik PubMed, MEDLINE, PMC, Cochrane Library, Nature, Taylor and Francis Online dan Springerlink, dari tanggal 28 Desember 2017 sampai 20 Februari 2018. Kriteria inklusi: burst fracture dari mekanisme traumatik, fraktur tulang belakang bagian thorax atau lumbal, intermediate pedicle screw dan penelitian dari tahun 2010 sampai 2017. Ditemukan 10 artikel (15,15%) artikel yang masuk kedalam kriteria inklusi. Terdapat tiga penelitian level 1, satu penelitian level 2, empat penelitian level 3 yang mendukung teknik SSPF+IS dengan hasil reduksi fraktur dan evaluasi radiologis yang baik, correction loss dan implant failure yang lebih rendah, mengurangi nyeri pascaoperasi. Teknik SSPF+IS merupakan teknik yang aman dan efektif memberikan hasil fiksasi yang stabil, hasil evaluasi akhir radiologis serta hasil evaluasi akhir klinis yang baik.

scholarly journals Intermediate Screw pada Unstable Thoracolumbar Fracture: Case Series dan Review Article

2018 ◽  
Vol 7 (3) ◽  
pp. 387
Author(s):  
Komang Agung Irianto ◽  
Dionisius Bramta Putra
Keyword(s):  
Pedicle Screw ◽  
Burst Fracture ◽  
Case Series ◽  
Cochrane Library ◽  
Correction Loss ◽  
Short Segment ◽  
Level 3 ◽  
Level 1 ◽  
Short Segment Fixation ◽  
Level 2

Area thorakolumbar merupakan hampir 90% dari semua spinal injuries dan 10% dari cedera tersebut merupakan burst fracture yang membutuhkan intervensi operatif. Terapi burst fracture thorakolumbar meliputi restorasi dari alignment, stabilisasi spinal, koreksi kifotik, dan dekompresi spinal kanal. Pertimbangan penggunaan intermediate screw masih menjadi topik perdebatan. Penambahan intermediate pedicle screw dipercaya dapat menambah stabilitas dan membantu koreksi kifosis pada long segment, short segment fixation. Penelitian ini merupakan systematic literature review. Pencarian literatur menggunakan mesin pencari elektronik PubMed, MEDLINE, PMC, Cochrane Library, Nature, Taylor and Francis Online dan Springerlink, dari tanggal 28 Desember 2017 sampai 20 Februari 2018. Kriteria inklusi: burst fracture dari mekanisme traumatik, fraktur tulang belakang bagian thorax atau lumbal, intermediate pedicle screw dan penelitian dari tahun 2010 sampai 2017. Ditemukan 10 artikel (15,15%) artikel yang masuk kedalam kriteria inklusi. Terdapat tiga penelitian level 1, satu penelitian level 2, empat penelitian level 3 yang mendukung teknik SSPF+IS dengan hasil reduksi fraktur dan evaluasi radiologis yang baik, correction loss dan implant failure yang lebih rendah, mengurangi nyeri pascaoperasi. Teknik SSPF+IS merupakan teknik yang aman dan efektif memberikan hasil fiksasi yang stabil, hasil evaluasi akhir radiologis serta hasil evaluasi akhir klinis yang baik.

scholarly journals The Hardware Failure and Correction Loss of Short-segment Pedicle Screw Fixation Combined With Transforaminal Interbody Fusion in Treatment of Unstable Thoracolumbar Burst Fracture: Retrospective Study in Vietnam

2021 ◽  
Author(s):  
Ngoc Quyen Nguyen ◽  
Trong Hau Phan ◽  
Van Hong Vu
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Correction Loss ◽  
Short Segment ◽  
Hardware Failure ◽  
Transforaminal Interbody Fusion

Abstract Background: Correction loss and hardware failure of short segment posterior pedicle screw fixation in treatment of thoracolumbar unstable burst fracture have been remaining a main concern. Several authors have introduced the procedures to solve these limitations including transforaminal interbody fusion (TIF). The purposes of this study were to evaluate the progressive kyphosis and implant failure of short-segment pedicle screw fixation combined with transforaminal interbody fusion in treatment of unstable thoracolumbar burst fracture.Methods: The retrospective study were enrolled in the patients with isolated unstable thoracolumbar burst fractures, Denis type IIB who were treated by posterior short fixation with TIF between January 2013 to January 2017. Patients were followed up for a minimum of one and half year. For evaluation of correction loss, % loss of anterior vertebral body heights (%AVB), vertebral kyphotic angle (VA) and regional kyphotic angle (RA) were collected preoperatively, postoperatively and at final follow-up. The hardware failure was assessed on radiological images at last follow-up. Results: There were 36 patients who met the inclusion criteria with a mean follow-up duration of 53 months. The mean correction loss of %AVB, VA and, RA were 10.2%, 2.9o and 5.6o, respectively. There were 6 patients (16.7%) with hardware failure at final follow-up. Conclusions: Short-segment posterior pedicle screw fixation with TIF using bone chip graft hasn’t prevented completely the hardware failure and progressive kyphosis in treatment of unstable thoracolumbar burst fracture.

scholarly journals Posterior fixation including the fractured vertebra in short segment fixation of unstable thoracolumbar junction burst fractures

2016 ◽  
Vol 9 (2) ◽  
pp. 81
Author(s):  
Md. Kamrul Ahsan ◽  
Zabed Zahangiri ◽  
M. A. Awwal ◽  
Naznin Zaman ◽  
Md. Hamidul Haque ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Junction ◽  
Vertebral Height ◽  
Short Segment ◽  
The Mean ◽  
Short Segment Fixation

<p>The aim of this study was to evaluate the efficacy of inclusion of the fractured vertebra in short segment fixation in terms of clinical and the radiological outcomes in unstable thoracolumbar junction burst fractures at a minimum of 1 year follow-up. Records of 52 patients (age: 21-50 years) with thoracolumbar burst fracture (T10–L2) in Magerl Type A fractures underwent posterior pedicle screw fixation including the fractured vertebra. Clinical parameters were back pain using Visual Analogue Score (VAS) and disability using Oswestry disability index (ODI), neurological deficit (using ASIA grade) and radiologic parameters (Cobb angle, the kyphotic deformation and vertebral height) were measured before surgery and at 3, 6 and 12 months  post-operatively. The presence of screw breakage, screw pullout, peri-implant loosening, and rod breakage were considered as criteria for implant failure. The majority of fractures resulted due to falls (31 cases), and the remaining cases resulted from car accidents (21 cases). The fractured vertebral body level was L1, T12, L2, T11, and T10 in 23, 17, 6, 4 and 2 cases and achieved satisfactory clinical outcomes according to the modified Mcnab criteria 18, 25, 6 and 3 cases were considered to have excellent, good, fair, and poor outcome. The mean kyphotic angle at pre-, post-operative and final follow-up was 13.5 ± 6.3, 13.4 ± 4.3, 8.5 ± 6.  The average loss of kyphosis correction was 6.4 ± 5.2° at the final follow-up. The mean pre- and post-operative kyphotic deformation of vertebral body was 5.1 ± 3.2, 4.8 ± 2.3 and at final follow-up was 4.5 ± 4.0 (p&gt;0.05). The mean anterior and posterior vertebral height also showed significant improvements post-operatively, which were maintained at the final follow-up. The mean ODI and VAS scores at the end of 1 year were 17.4%, 1.7 respectively. There was no case of major complication after surgery and during the follow-up period. In conclusion, reduction of unstable thoracolumbar junction burst fracture can be achieved and maintained with the use of short-segment pedicle screw fixation including the fractured vertebra, avoiding the need for anterior reconstruction.</p><p> </p>

EVALUASI PELATIHAN DI PT. PUPUK KUJANG CIKAMPEK

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Lania Muharsih ◽  
Ratih Saraswati
Keyword(s):  
Training Evaluation ◽  
Work Productivity ◽  
Learning Behavior ◽  
Level 3 ◽  
Level 1 ◽  
Four Levels ◽  
A Company ◽  
Level 2 ◽  
Evaluation Sheet ◽  
Assessment Factor

This study aims to determine the training evaluation at PT. Kujang Fertilizer. PT. Pupuk Kujang is a company engaged in the field of petrochemicals. Evaluation sheet of PT. Fertilizer Kujang is made based on Kirkpatrick's theory which consists of four levels of evaluation, namely reaction, learning, behavior, and results. At level 1, namely reaction, in the evaluation sheet is in accordance with the theory of Kirkpatrick, at level 2 that is learning should be held pretest and posttest but only made scale. At level 3, behavior, according to theory, but on assessment factor number 3, quantity and work productivity should not need to be included because they are included in level 4. At level 4, that is the result, here is still lacking to get a picture of the results of the training that has been carried out because only based on answers from superiors without evidence of any documents.   Keywords: Training Evaluation, Kirkpatrick Theory.    Penelitian ini bertujuan mengetahui evaluasi training di PT. Pupuk Kujang. PT. Pupuk Kujang merupakan perusahaan yang bergerak di bidang petrokimia. Lembar evaluasi PT. Pupuk Kujang dibuat berdasarkan teori Kirkpatrick yang terdiri dari empat level evaluasi, yaitu reaksi, learning, behavior, dan hasil. Pada level 1 yaitu reaksi, di lembar evaluasi tersebut sudah sesuai dengan teori dari Kirkpatrick, pada level 2 yaitu learning seharusnya diadakan pretest dan posttest namun hanya dibuatkan skala. Pada level 3 yaitu behavior, sudah sesuai teori namun pada faktor penilaian nomor 3 kuantitas dan produktivitas kerja semestinya tidak perlu dimasukkan karena sudah termasuk ke dalam level 4. Pada level 4 yaitu hasil, disini masih sangat kurang untuk mendapatkan gambaran hasil dari pelatihan yang sudah dilaksanakan karena hanya berdasarkan dari jawaban atasan tanpa bukti dokumen apapun.   Kata kunci: Evaluasi Pelatihan, Teori Kirkpatrick.

scholarly journals An Atmospheric Visibility Grading Method Based on Ensemble Learning and Stochastic Weight Average

Atmosphere ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 869
Author(s):  
Xiuguo Zou ◽  
Jiahong Wu ◽  
Zhibin Cao ◽  
Yan Qian ◽  
Shixiu Zhang ◽  
...  
Keyword(s):  
Ensemble Learning ◽  
Traffic Accidents ◽  
Feature Sets ◽  
Atmospheric Visibility ◽  
Average Accuracy ◽  
Level 3 ◽  
Visual Characteristics ◽  
Level 1 ◽  
Grading Model ◽  
Level 2

In order to adequately characterize the visual characteristics of atmospheric visibility and overcome the disadvantages of the traditional atmospheric visibility measurement method with significant dependence on preset reference objects, high cost, and complicated steps, this paper proposed an ensemble learning method for atmospheric visibility grading based on deep neural network and stochastic weight averaging. An experiment was conducted using the scene of an expressway, and three visibility levels were set, i.e., Level 1, Level 2, and Level 3. Firstly, the EfficientNet was transferred to extract the abstract features of the images. Then, training and grading were performed on the feature sets through the SoftMax regression model. Subsequently, the feature sets were ensembled using the method of stochastic weight averaging to obtain the atmospheric visibility grading model. The obtained datasets were input into the grading model and tested. The grading model classified the results into three categories, with the grading accuracy being 95.00%, 89.45%, and 90.91%, respectively, and the average accuracy of 91.79%. The results obtained by the proposed method were compared with those obtained by the existing methods, and the proposed method showed better performance than those of other methods. This method can be used to classify the atmospheric visibility of traffic and reduce the incidence of traffic accidents caused by atmospheric visibility.

Role of Including the Index level in Short Segment Pedicular Fixation in Traumatic Thoraco-Lumbar Fractures

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ayman Abd-El-Ra’ouf EL-Shazly ◽  
Salah Mostafa Hamada ◽  
Ahmed Maged Nagaty ◽  
Ahmed Adel Nabih
Keyword(s):  
Pedicle Screw ◽  
Thoracolumbar Fractures ◽  
Spine Trauma ◽  
Kyphosis Angle ◽  
Short Segment ◽  
Loss Of Correction ◽  
Significant Difference ◽  
Index Level ◽  
Short Segment Fixation ◽  
Fracture Level

Abstract Background It is generally acknowledged that short-segment pedicle screw instrumentation is the preferred surgical method for thoracolumbar fractures. However, the use of short-segment instrumentation with or without intermediate screws at the fracture level remains controversial. This review will evaluate the evidence available to date regarding the efficacy of including the fracture level in trans-pedicular screw short segment fixation, to assess clinical and radiological outcome. Objectives Our primary objective is evaluating the efficacy and outcome of including the fractured level vertebra in short segment fixation. And concerns regarding the use of pedicle screws into the fractured vertebra as to whether it is safe to insert a screw through a broken bone. Our secondary objective analyzing the importance of posterior pedicle screw fixation in unstable thoracolumbar fractures. Methods The following electronic databases will be searched from 1992 to 2018: PubMed, Google scholar search engine. Cochrane database of systematic reviews, EMBASE and science Direct, using the keywords “TLICS”, "index screw", “short segment fixation”, "Thoracolumbar spine trauma", "traumatic spine injury", "spinal cord injury", "spine trauma", "role", “reliability”.Studies will be eligible if they contain the target keywords in title or abstract, addressing our age group. Afterwards the full text of the articles will be reviewed to exclude full texts not fulfilling the criteria or deviating from the initial impression taken from the title/abstract reviewing. References/bibliography of the selected articles will be examined to evaluate potential for further research and possible inclusion in the analysis. Any differences will be sorted by discussion between study team (student, director, and co-directors). Results A total of 3010 studies were screened for eligibility , 8 studies were included in our systematic review for comparing the short segment fixation “including” the fracture level with “conventional” methods whether short or long segment fixation. Overall study population reached 512 patients. Analysis showed comparable results regarding clinical picture and radiography, showing highly statistically significant difference in favor of “including” index level in fixation in post operative kyphosis angle correction, loss of correction of kyphosis angle through follow up until 2 years and loss of correction of AVH, also statistically significant difference in rate of implant failure in favor for “including” group, and with no significant difference in operative time , blood loss and VAS for post-operative pain. Conclusion We conclude that Short segment fixation including the fracture level is a promising surgical option when it comes to thoraco-lumbar unstable fractures. In conclusion, inclusion of the fracture level into the construct offers a better kyphosis correction, in addition to fewer instrument failures, without additional complications, and with a comparable-if not better-clinical outcome, the radiologic correction achieved is maintained even at the end of 2 years and reflected in good functional outcomes. We recommend insertion of screws into pedicles of the fractured thoracolumbar vertebra when considering a short segment posterior fixation, especially in Magerl type C fractures. Large population prospective randomized controlled studies and clinical trials are recommended for more high level evidence data.

The Magical Number Two, Plus or Minus One: Some Limits on our Capacity for Processing Musical Information

2002 ◽  
Vol 6 (2) ◽  
pp. 185-219 ◽  
Author(s):  
Adam Ockelford
Keyword(s):  
Cognitive Processing ◽  
General Principle ◽  
Empirical Work ◽  
Theoretical Framework ◽  
Musical Structure ◽  
Magical Number ◽  
Level 3 ◽  
Level 1 ◽  
Level 2

Like all fields of human artistic endeavour, music is constrained by our cognitive processing requirements and limitations (Swain, 1986; Lerdahl, 1988; Huron, 2001). This articleconsiders particular forms of constraint pertaining to the relationships that the structure-seeking mind (subconsciously) fabricates between perceived musical events. It is proposed that 2±1 may be a universal limitation pertaining to the level of relationships so ideated. That is, in terms of Lewin'S (1987) theoretical framework in which “intervals” can be intuited between the “elements” of musical “spaces”, it is posited that the cognition of musical structure occurs either through intervals (level 1), through intervals between these (level 2), or — in some circumstances — through intervals between these(level 3). This proposition is explored through the psychomusicological model developed by Ockelford (1991, 1993, 1999), which too analyses musical structure in terms of the relationships that may be cognised between its discrete perceptual components. In particular, the model identifies a type of cognitive link through which events (at any level) arefelt to imply others the same or similar — through so-called “zygonic” relationships. This theory suggests a further general principle: that the highest level of relationship inoperation at any given point must be zygonic if the music is to be structurally coherent. Evidence for this, and for the limit on the level of relationships of 2±1, is offeredthrough a series of musical examples, which illustrate a variety of musical organisation in action. Finally, empirical work is suggested to explore further the theoretical ideas that arepresented here.

Systems biology markup language: Level 2 and beyond

2003 ◽  
Vol 31 (6) ◽  
pp. 1472-1473 ◽  
Author(s):  
A. Finney ◽  
M. Hucka
Keyword(s):  
Systems Biology ◽  
Computational Models ◽  
Chemical Species ◽  
Biochemical Networks ◽  
Markup Language ◽  
Exchange Format ◽  
Systems Biology Markup Language ◽  
Level 3 ◽  
Level 1 ◽  
Level 2

The SBML (systems biology markup language) is a standard exchange format for computational models of biochemical networks. We continue developing SBML collaboratively with the modelling community to meet their evolving needs. The recently introduced SBML Level 2 includes several enhancements to the original Level 1, and features under development for SBML Level 3 include model composition, multistate chemical species and diagrams.

Knowledge Acquired from Learning: New Evidence of Hierarchical Conceptualization

1994 ◽  
Vol 79 (2) ◽  
pp. 975-993 ◽  
Author(s):  
Alberto Montare
Keyword(s):  
Sex Differences ◽  
Knowledge Acquisition ◽  
Reversal Learning ◽  
Concept Formation ◽  
Learning Task ◽  
Learning Rates ◽  
Level 3 ◽  
Level 1 ◽  
New Evidence ◽  
Level 2

Following successful inductive acquisition of procedural cognition of a discrimination-reversal learning task, 50 female and 50 male undergraduates articulated declarative cognizance of knowledge acquired from learning. Tests of four hypotheses showed that (1) increasingly higher levels of declarative cognizance were associated with faster learning rates, (2) six new cases of cognition-without-cognizance were observed, (3) students presumably using secondary signalization learned faster than those presumably using primary signalization, and (4) no sex differences in learning rates or declarative cognizance were observed. The notion that explicit levels of declarative cognizance may represent implicit hierarchical conceptualization comprised of four systems of knowledge acquisition led to the conclusions that primary signalization may account for inductive senscept formation at Level 1 and for inductive percept formation at Level 2, whereas emergent secondary signalization may account for inductive precept formation at Level 3 and for inductive concept formation at Level 4.

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