• Title/Summary/Keyword: Fusion Age

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A Lower T1 Slope as a Predictor of Subsidence in Anterior Cervical Discectomy and Fusion with Stand-Alone Cages

  • Lee, Su Hun;Lee, Jun Seok;Sung, Soon Ki;Son, Dong Wuk;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.567-576
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    • 2017
  • Objective : Preoperative parameters including the T1 slope (T1S) and C2-C7 sagittal vertical axis (SVA) have been recognized as predictors of kyphosis after laminoplasty, which is accompanied by posterior neck muscle damage. The importance of preoperative parameters has been under-estimated in anterior cervical discectomy and fusion (ACDF) because there is no posterior neck muscle damage. We aimed to determine whether postoperative subsidence and pseudarthrosis could be predicted according to specific parameters on preoperative plain radiographs. Methods : We retrospectively analyzed 41 consecutive patients (male : female, 22 : 19; mean age, $51.15{\pm}9.25years$) who underwent ACDF with a stand-alone polyether-ether-ketone (PEEK) cage (>1 year follow-up). Parameters including SVA, T1S, segmental angle and range of motion (ROM), C2-C7 cervical angle and ROM, and segmental inter-spinous distance were measured on preoperative plain radiographs. Risk factors of subsidence and pseudarthrosis were determined using multivariate logistic regression. Results : Fifty-five segments (27 single-segment and 14 two-segment fusions) were included. The subsidence and pseudarthrosis rates based on the number of segments were 36.4% and 29.1%, respectively. Demographic data and fusion level were unrelated to subsidence. A greater T1S was associated with a lower risk of subsidence (p=0.017, odds ratio=0.206). A cutoff value of T1S<$28^{\circ}$ significantly predicted subsidence (sensitivity : 70%, specificity : 68.6%). There were no preoperative predictors of pseudarthrosis except old age. Conclusion : A lower T1S (T1S<$28^{\circ}$) could be a risk factor of subsidence following ACDF. Surgeons need to be aware of this risk factor and should consider various supportive procedures to reduce the subsidence rates for such cases.

Effect of Dietary Calcium on Spinal Bone Fusion in an Ovariectomized Rat Model

  • Cho, Jae-Hoon;Cho, Dae-Chul;Yu, Song-Hee;Jeon, Young-Hoon;Sung, Joo-Kyung;Kim, Kyoung-Tae
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.281-287
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    • 2012
  • Objective : To evaluate the effect of calcium supplementation on spinal bone fusion in ovariectomized (OVX) rats. Methods : Sixteen female Sprague Dawley rats underwent bilateral ovariectomy at 12 weeks of age to induce osteoporosis and were randomly assigned to two groups : control group (n=8) and calcium-supplemented group (OVX-Ca, n=8). Autologous spinal bone fusion surgery was performed on both groups 8 weeks later. After fusion surgery, the OVX-Ca group was supplemented with calcium in drinking water for 8 weeks. Blood was obtained 4 and 8 weeks after fusion surgery. Eight weeks after fusion surgery, the rats were euthanized and the L4-5 spine removed. Bone fusion status and fusion volume were evaluated by manual palpation and three-dimensional computed tomography. Results : The mean fusion volume in the L4-5 spine was significantly greater in the OVX-Ca group ($71.80{\pm}8.06mm^3$) than in controls ($35.34{\pm}8.24mm^3$) (p<0.01). The level of osteocalcin, a bone formation marker, was higher in OVX-Ca rats than in controls 4 weeks ($610.08{\pm}10.41$ vs. $551.61{\pm}12.34$ ng/mL) and 8 weeks ($552.05{\pm}19.67$ vs. $502.98{\pm}22.76$ ng/mL) after fusion surgery (p<0.05). The level of C-terminal telopeptide fragment of type I collagen, a bone resorption marker, was significantly lower in OVX-Ca rats than in controls 4 weeks ($77.07{\pm}12.57$ vs. $101.75{\pm}7.20$ ng/mL) and 8 weeks ($69.58{\pm}2.45$ vs. $77.15{\pm}4.10$ ng/mL) after fusion surgery (p<0.05). A mechanical strength test showed that the L4-5 vertebrae in the OVX-Ca group withstood a 50% higher maximal load compared with the controls (p<0.01). Conclusion : Dietary calcium given to OVX rats after lumbar fusion surgery improved fusion volume and mechanical strength in an ovariectomized rat model.

Perioperative Results and Complications after Posterior Lumbar Interbody Fusion for Spinal Stenosis in Geriatric Patients over than 70 Years Old

  • Choi, Jong Min;Choi, Man Kyu;Kim, Sung Bum
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.684-690
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    • 2017
  • Objective : As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). Methods : We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years. We divided into 2 groups (A; 70-75 years, B; over then 76 years) according to the age. Surgical level of each groups, hospital day and postoperative day, co-morbidities, complications, clinical outcomes were analyzed. Operative reports, hospital and outpatient clinic charts, and radiographic studies were reviewed. Results : Group A was composed of 80 patients, their mean age was 72.21 and female dominant (n=46), and their mean surgically fused level was 1.52 level. Group B was 36 patients, their mean age was 78.83 and female dominant (n=20), and their mean surgically fused level was 1.36 level. Comparing between two groups, complications, postoperative hospital stay were slightly increase in group B and co-morbidity was statistically high in group B, however clinical outcomes were similar between two groups. Conclusion : Increasing age might be an important risk factor for complications in patients undergoing PLIF, however, we would like to recommend that if the situation of spine of extreme geriatric patients need PLIF, it should be in the surgeon's consideration after careful selection and clinical judgement.

Radiographic Evaluation of Limb Bone Development in Miniature Porcine (미니돼지의 팔다리 뼈 성장에 대한 방사선학적 평가)

  • Chang, Jin-Hwa;Jung, Joo-Hyun;Choi, Min-Cheol
    • Journal of Life Science
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    • v.17 no.10
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    • pp.1315-1320
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    • 2007
  • Epiphyseal development in the long bones was studied radiographically in minipigs. Radiographs of the proximal and distal epiphyses of humerus, radius, ulna, femur and tibia were obtained at 4, 8, 12, 20, 40, 48, 96 and 144 weeks of age in total 58 minipigs. The assessment of maturity process was made in accordance with the criteria proposed by Owada and Sutow. The secondary ossification centers developed rapidly from 4 weeks of age to 40 weeks of age, and gradually thereafter until 96 weeks of age. The earliest epiphyseal fusion was apparent in the proximal radius, proximal and distal femur at 96 weeks of age. The complete fusion of the epiphyseal line in the long bones was evident on 144 weeks of age and was observed in most long bones such as the proximal humerus, the proximal and distal ulna and the distal radius, and the proximal tibia in minipigs.

Evaluation of root and root canal morphology of elderly Korean patients maxillary molars using cone-beam computed tomography (CBCT를 이용한 한국인 고령환자의 상악 대구치에서 치근 및 근관형태의 분석)

  • Lee, Tae-Yong;Kim, Mi-Yeon;Kim, Sun-Ho;Kim, Jeong-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.2
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    • pp.95-102
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    • 2020
  • Purpose:The aim of the present study was to evaluate the incidence of the second mesiobuccal (MB2) canal, root fusion, and C-shaped root canal configuration in the Korean maxillary first (MM1) and second (MM2) molars by analyzing cone-beam computed tomographic (CBCT) images. Materials and methods: Patients undergoing presurgical CBCT examination were included in the current study. The CBCT images of 1498 MM1 and 1742 MM2 from 1658 Korean patients were assessed to determine the incidence of a MB2 canal, the types of canal configurations, root fusion, and C-shaped root canal configurations. Further, the correlations between the incidence of MB2 canal and age, gender, and tooth position were analyzed. Results: The study population was relatively old (mean age: 66.1 years). The percentage of MB2 canals in MB roots was 60.1% and 28.0% in MM1 and MM2, respectively, with the most common configurations being Weine type III in MM1 and Weine type II in MM2. Additionally, the frequency of a MB2 canal decreased with age in both molars and was higher in men than in women in the MM1 only. Furthermore, root fusion was present in 2.3% and 26.2% of the MM1 and MM2, respectively, whereas C-shaped root canals were observed in 0.4% and 2.7% of the MM1 and MM2, respectively. Conclusion: The MB2 canal was found more frequently in the MM1, whereas root fusion and C-shaped root canals were both seen more frequently in the MM2.

Studies on the culture of bovine nuclear transplant embryos derived in vitro fertilization (체외수정 유래 소 핵이식란의 배양에 관한 연구)

  • Hwang, Woo-suk;Jo, Choong-ho
    • Korean Journal of Veterinary Research
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    • v.35 no.1
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    • pp.179-185
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    • 1995
  • The fusion rates of nuclear transplant embryos with various DC voltage were 55.6-79.2%. The significantly higher fusion rates of nuclear transplant embryos were achieved at the electric field strenght of DC 1.0-2.0kV/cm(72.0-79.2%) than DC 0.75kV/cm(55.6%, P<0.05). No significant differences in the percentage of embryos that cleaved(48.1, 55.4 and 42.6% respectively) and the percentage of cleaved embryos that developed to morulae/blastocyst(1.9, 5.3 and 1.9% respectively) could be found among the three types of in vitro culture system (Granulosa cell, BOEC co-culture and SOF, P>0.01). The age of the recipient cytoplast(30 vs 40hr) had no effect on the fusion rates and the rates of cleavage development(36.9 vs 44.1%, P>0.01).

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Intelligent User Pattern Recognition based on Vision, Audio and Activity for Abnormal Event Detections of Single Households

  • Jung, Ju-Ho;Ahn, Jun-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.5
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    • pp.59-66
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    • 2019
  • According to the KT telecommunication statistics, people stayed inside their houses on an average of 11.9 hours a day. As well as, according to NSC statistics in the united states, people regardless of age are injured for a variety of reasons in their houses. For purposes of this research, we have investigated an abnormal event detection algorithm to classify infrequently occurring behaviors as accidents, health emergencies, etc. in their daily lives. We propose a fusion method that combines three classification algorithms with vision pattern, audio pattern, and activity pattern to detect unusual user events. The vision pattern algorithm identifies people and objects based on video data collected through home CCTV. The audio and activity pattern algorithms classify user audio and activity behaviors using the data collected from built-in sensors on their smartphones in their houses. We evaluated the proposed individual pattern algorithm and fusion method based on multiple scenarios.

Accelerated L5-S1 Segment Degeneration after Spinal Fusion on and above L4-5 : Minimum 4-Year Follow-Up Results

  • Park, Jeong-Yoon;Chin, Dong-Kyu;Cho, Yong-Eun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.2
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    • pp.81-84
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    • 2009
  • Objective : Many biomechanical and clinical studies on adjacent segment degeneration (ASD) have addressed cranial segment. No study has been conducted on caudal segment degeneration after upper segment multiple lumbar fusions. This is a retrospective investigation of the L5-S1 segment after spinal fusion at and above L4-5, which was undertaken to analyze the rate of caudal ASD at L5-S1 after spinal fusion on and above L4-5 and to determine that factors that might have influenced it. Methods : The authors included 67 patients with L4-5, L3-5, or L2-5 posterior fusions. Among these patients, 28 underwent L4-5 fusion, 23 L3-5, and 16 L2-5 fusions. Pre- and postoperative radiographs were analyzed to assess degenerative changes at L5-S1. Also, clinical results after fusion surgery were analyzed. Results : Among the 67 patients, 3 had pseudoarthrosis, and 35 had no evidence of ASD, cranially and caudally. Thirteen patients (19.4%) showed caudal ASD, 23 (34.3%) cranial ASD, and 4 (6.0%) both cranial and caudal ASD. Correlation analysis for caudal ASD at L5-S1 showed that pre-existing L5-S1 degeneration was most strongly correlated. In addition, numbers of fusion segments and age were also found to be correlated. Clinical outcome was not correlated with caudal ASD at L5-S1. Conclusion : If caudal and cranial ASD are considered, the overall occurrence rate of ASD increases to 50%. The incidence rate of caudal ASD at L5-S1 was significantly lower than that of cranial ASD. Furthermore, the occurrence of caudal ASD was found to be significantly correlated with pre-existing disc degeneration.

TMPRSS2:ETS Fusions and Clinicopathologic Characteristics of Prostate Cancer Patients from Eastern China

  • Dong, Jun;Xiao, Li;Sheng, Lu;Xu, Jun;Sun, Zhong-Quan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3099-3103
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    • 2014
  • TMPRSS2:ERG gene fusions in prostate cancer have a dominant prevalence of approximately 50.0%, but infomration is limited on differences among ethnic and geographical groups. Some studies focusing on Japanese and Korean patients reported a lower incidence. Investigations concerning Chinese revealed controversial results. We evaluated TMPRSS2:ERG, TMPRSS2:ETV1 and TMPRSS2:ETV4 fusions in more than 100 Eastern Chinese prostate cancer patients. Paraffin blocks of needle biopsy and radical prostatectomy were collected from 91 and 18 patients respectively. All patients' clinicopathologic factors were gathered. TMPRSS2:ERG, TMPRSS2:ETV1 and TMPRSS2:ETV4 fusions were tested by multi-probe fluorescence in situ hybridization (FISH) assay. TMPRSS2:ERG fusions was present in 14.3% biopsy specimens and 11.1% radical prostatectomy patients. Neither TMPRSS2:ETV1 nor TMPRSS2:ETV4 fusion was found in any case. Altogether, 13 (86.7%) TMPRSS2:ERG fusion positive cases possessed deletion pattern and 7 (46.6%) and insertion pattern. Some 5 cases had both deletion and insertion patterns. While 38.5% (5/13) patients with deletion pattern had distant metastasis, except for one metastatic case harboring both deletion and insertion, there were no patients with insertion pattern accompanied with metastasis. There were no differences between fusion positive and negative cases in the distribution of age, PSA, Gleason score and TNM stage. Eastern Chinese prostate cancer patients have a significantly low incidence of TMPRSS2:ERG fusion. They also lack TMPRSS2:ETV1 and TMPRSS2:ETV4 fusion. There are more deletion pattern than insertion pattern in TMPRSS2:ERG positive cases. Fusion positive and negative patients have no clinicopathologic factor differences.

Clinical Analysis of Postoperative Prognostic Factors of Cervical Anterior Decompression and Interbody Fusion for Ossification of Posterior Longitudinal Ligament (경추 후종인대 골화증의 전방경유 감압술 및 골 융합술후 예후인자에 대한 임상분석)

  • Sim, Sang Joon;Cho, Jun Ho;Yoo, Soo Il;Kwon, Young Dae;Lee, Yong Sung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.360-364
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    • 2000
  • Objective : To investigate the prognostic factors associated with outcome in patients with ossification of posterior longitudinal ligament. Method : During the past 4 years, we have operated on 35 patients with cervical OPLL. Anterior cervical decompression(total or subtotal corpectomy, discectomy, and removal of the OPLL) and interbody fusion with iliac bone were performed in all patients. Results : Eight cases(22.9%) were continuous type, 11(31.4%) segmental, 13(37.1%) Mixed, and 3(8.6%) localized type. Thirty-two patients(91.4%) showed an excellent or good results. Conclusion : These results indicate that surgical treatment should be considerated in case of clinical grading higher than II and the surgical outcome is worse when duration of preoperative symptom is longer and when percentage of spinal narrowing is higher. Anterior cervical decompression and interbody fusion seems to be a better method in patients with lesions limited to one or two level. Age at surgery did not significantly affect the outcom.

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