Comparative Analysis of Cage Subsidence in Anterior Cervical Decompression and Fusion: Zero Profile Anchored Spacer (ROI-C) vs. Conventional Cage and Plate Construct

Background: Anterior cervical discectomy and fusion (ACDF) has been widely performed to treat cervical generative diseases. Cage subsidence is a complication after ACDF. Although it is known that segmental kyphosis, acceleration of adjacent segmental disease, and restenosis may occur due to cages subsidence; however detailed research comparing zero-profile cages (ROI-C) and conventional plate and cage construct (CPC) on cage subsidence has been lacking.Objective: The objectives of this study was to compare the rate of postoperative cage subsidence between zero profile anchored spacer (ROI-C) and conventional cage and plate construct (CPC) and investigate the risk factors associated with cage subsidence following ACDF.Methods: Seventy-four patients with ACDF who received either ROI-C or CPC treatment from October 2013 to August 2018 were included in this retrospective cohort study. Clinical and radiological outcomes and the incidence of cage subsidence at final follow up-were compared between groups. All patients were further categorized into the cage subsidence (CS) and non-cage subsidence (NCS) groups for subgroup analysis.Results: The overall subsidence rate was higher in the ROI-C group than in the CPC group (66.67 vs. 38.46%, P = 0.006). The incidence of cage subsidence was significantly different between groups for multiple-segment surgeries (75 vs. 34.6%, P = 0.003), but not for single-segment surgeries (54.55 vs. 42.30%, P = 0.563). Male sex, operation in multiple segments, using an ROI-C, and over-distraction increased the risk of subsidence. Clinical outcomes and fusion rates were not affected by cage subsidence.Conclusion: ROI-C use resulted in a higher subsidence rate than CPC use in multi-segment ACDF procedures. The male sex, the use of ROI-C, operation in multiple segments, and over-distraction were the most significant factors associated with an increase in the risk of cage subsidence.

Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation

<p class="abstract"><strong>Background:</strong> A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.</p><p class="abstract"><strong>Methods:</strong> The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest.</p>

ANALYSIS OF PACKAGING PRINT QUALITY WITH CTF AND CTCP PLATE MAKING SYSTEMS USING DUPLEX PAPER MATERIALS

Comparative analysis of packaging print quality was carried out on the printed output with reference to using Computer to Film (CtF) and Computer to Conventional Plate (CtCP). The comparison of the print results from the two systems is analyzed from cost, durability, and dot gain. In this analysis, 400 gram duplex paper was used and two types of print references were used, namely CtF and CtCP. The pre-printing equipment used is the manufacture of conventional printing plates and plates. What is achieved when observing is comparing two print references with the help of a quality control (QC) tool. Before comparing the two print references, direct printing is done with the two print references, using an offset machine. The differences that exist in CtF and CtCP are caused by different irradiation processes. CtF goes through two irradiation processes while CtCP is in the irradiation process using only lasers. The irradiation process using a laser is uneven and makes the plate not get a raster (neat) result. This process is very influential with the result of the trigger. CtF goes through an iterative process but the results appear better than CtCP.Keywords— Print packaging, Duplex, CtF, CtCp

Design optimization of two-span continuous composite box girder bridges

Composite steel box girder bridges have become an effective alternative to conventional plate girders and concrete girder bridges in North America in the past 25 years. A number of ongoing innovations in Canada and elsewhere have the potential of further enhancing the design, durability, constructability, and, by extension, the economics of steel box-girder bridges. The thesis examines number of boxes actually needed, with the aim of reducing the number used at present while meeting all design criteria.

Design optimization of two-span continuous composite box girder bridges

Composite steel box girder bridges have become an effective alternative to conventional plate girders and concrete girder bridges in North America in the past 25 years. A number of ongoing innovations in Canada and elsewhere have the potential of further enhancing the design, durability, constructability, and, by extension, the economics of steel box-girder bridges. The thesis examines number of boxes actually needed, with the aim of reducing the number used at present while meeting all design criteria.

Survival and proliferation of an opportunistic pathogen in mixed species biofilms

The purpose of this study was to examine the interaction between an opportunistic pathogen and mixed community biofilms, in terms of integration, proliferation and subsequent release. Pseudomonas aeruginosa PAO1 was used as the test strain in conjuction with community biofilms obtained from sink drains. Confocal laser scanning microscopy (CLSM) analysis showed that PAO1 could successfully incorporate into the community. The relative abundance of PAO1 in the biofilms was dependant on the order of inoculation. Biofilm cell yield was studied using conventional plate counting, CLSM and flow cytometry, which revealed that PAO1 became a dominant community member. Cells were released from the biofilms in the form of single cells, duplets and aggregates of various zies. Detached aggregates were often observed to contain PAO1 and community members. It was also determined that association with communities provided PAO1 with increased protection against EDTA but not against streptomycin, when applied at planktonic minimal inhibitory concentration.

Survival and proliferation of an opportunistic pathogen in mixed species biofilms

The purpose of this study was to examine the interaction between an opportunistic pathogen and mixed community biofilms, in terms of integration, proliferation and subsequent release. Pseudomonas aeruginosa PAO1 was used as the test strain in conjuction with community biofilms obtained from sink drains. Confocal laser scanning microscopy (CLSM) analysis showed that PAO1 could successfully incorporate into the community. The relative abundance of PAO1 in the biofilms was dependant on the order of inoculation. Biofilm cell yield was studied using conventional plate counting, CLSM and flow cytometry, which revealed that PAO1 became a dominant community member. Cells were released from the biofilms in the form of single cells, duplets and aggregates of various zies. Detached aggregates were often observed to contain PAO1 and community members. It was also determined that association with communities provided PAO1 with increased protection against EDTA but not against streptomycin, when applied at planktonic minimal inhibitory concentration.

One-Year Follow-Up After Treatment of Proximal and/or Middle One-Third Humeral Shaft Fractures with a Helical Plate: Healing Rates, Complications and Functional Outcome Measures

Background: Conventional plate osteosynthesis is a valuable treatment option in displaced proximal and/or middle one-third humeral shaft fractures. Nonetheless, this procedure can be complicated by a radial nerve palsy. To date, many surgical techniques have been developed in an attempt to minimize this high-impact complication. However, a helical plate has the potential to avoid an iatrogenic radial nerve palsy due to its design. This article aims to evaluate safety and functional outcomes of patients treated with a helical plate compared to conventional plate osteosynthesis. In particular healing rates, complications and functional outcome measures.Methods: We retrospectively included all patients with displaced proximal and/or middle one-third humeral shaft fractures who were treated with a helical plate from October 2016 until August 2018 at a single level-1 trauma center (AZ Groeninge, Kortrijk, Belgium). A self-molded long PHILOS plate (DePuy Synthes®) or a pre-contoured A.L.P.S proximal humeral plating system (Zimmer Biomet®) were used. Patient baseline characteristics and standard radiographs were obtained pre- and postoperatively. We retrospectively searched for complications. Patients were reassessed using the Disabilities of the Arm, Shoulder and Hand (DASH), Constant Murley (CMS) and EQ-5D-5L scores with a minimal follow-up of one year.Results: The humeral shaft fractures of all sixteen patients consolidated within three months and no iatrogenic radial nerve palsies were observed. One plate had to be removed after one year due to a late infection. With a minimum follow up of one year, the mean DASH score was 22 \ 19 and the mean normalized CMS was 80 B 19.Conclusion: Operative treatment of proximal and/or middle one-third humeral shaft fractures with a helical plate is a safe procedure with good to excellent shoulder function at one-year follow-up. Contrary to conventional plate osteosynthesis, a helical plate has the potential to completely avoid a radial nerve palsy, while maintaining similar healing rates and functional outcomes.Trial registration: B396201939564. Registered on 6 MAY 2019 – retrospectively registred. Ethics Committee: Medical Ethics Committee, AZ Groeninge, Kortrijk, Belgium.