Morphologic study of foramen oval region on surgery approach for trigeminal neuralgia.

Trigeminal neuralgia is a complex refractory neurologic disease. The foramen ovale puncture performs an important role in nerve anesthesia, balloon compression, focal gamma radiation, microvascular decompression, and radiofrequency nerve rhizotomy when the drug does not work. In this study, we provide some information about foramen oval region. Measuring the point at the distance of 2 cm beneath the zygomaxillare, which is close to the percutaneous insertion point and the center of foramen ovale and foramen spinosum separately, hoping to provide relatively accurate data for clinical treatment and avoiding some side injury of the puncture with computed tomography or x-ray navigation.

Multiple stress fractures: A case report and discussion.

Stress fracture is the result of bone destruction with prolonged and repetitive loading. It usually occurs among various groups, including athletes, military recruits, and others. Early stress fractures often undergo undiagnosed or misdiagnosed because of atypical symptoms and effective medical examination. Here, we report a rare clinical case about the multiple stress fractures in one adolescent. Expect for the pathological biopsy, it hardly gets confirm diagnosis. With the increasing population of sports lover, healthcare institutions should be enhanced their understanding of stress fractures and enable effective management at an early stage.

Osteoinductive Agents-Incorporated Three-Dimensional Biphasic Polymer Scaffold for Synergistic Bone Regeneration.

Large-scale bone defects are difficult to be regenerated entirely in the clinical practice. Bone tissue engineering has drawn more attention as an alternative to bone grafting owing to its convenience and flexibility. However, the low bioactivity of scaffolds and adverse effects of growth factors have hindered its practical application. Herein, the properties of poly(lactic-co-glycolic acid) (PLGA) scaffold, including hydrophilicity and mechanical strength, were improved by a gelatin coating incorporated with two small molecules, alendronate (ALD) and naringin (NG). Interestingly, these two drugs demonstrated a synergistic effect for the repair of rat calvarial defect, as ALD had an inhibitory impact on osteoclast activity and NG had an osteogenic effect on mesenchymal stem cells. From the results of histopathological staining and microcomputed tomography, the PLGA scaffold incorporated with gelatin, ALD, and NG (PLGA+Gelatin/ALD/NG) almost completely repaired the rat calvarial defect with physiological integrity at 16 weeks. In all, this biphasic scaffold can be a promising alternative to the conventional scaffold for clinical application.

Collagen-Coated Poly(lactide-co-glycolide)/Hydroxyapatite Scaffold Incorporated with DGEA Peptide for Synergistic Repair of Skull Defect.

The treatment of large-area bone defects remains a challenge; however, various strategies have been developed to improve the performances of scaffolds in bone tissue engineering. In this study, poly(lactide-co-glycolide)/hydroxyapatite (PLGA/HA) scaffold was coated with Asp-Gly-Glu-Ala (DGEA)-incorporated collagen for the repair of rat skull defect. Our results indicated that the mechanical strength and hydrophilicity of the PLGA/HA scaffold were clearly improved and conducive to cell adhesion and proliferation. The collagen-coated scaffold with DGEA significantly promoted the repair of skull defect. These findings indicated that a combination of collagen coating and DGEA improved scaffold properties for bone regeneration, thereby providing a new potential strategy for scaffold design.

Bryan Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion for Treatment of Cervical Disc Diseases: A Meta-analysis of Prospective, Randomized Controlled Trials.

STUDY DESIGN: A meta-analysis of randomized controlled trials (RCTs). OBJECTIVE: The purpose of this study is to evaluate the effectiveness and safety of Bryan cervical disc arthroplasty (BCDA) as compared with anterior cervical discectomy and fusion (ACDF) for treatment of cervical disc diseases (CDDs). SUMMARY OF BACKGROUND DATA: Previous meta-analyses focused on the comparison of effectiveness and safety between ACDF and CDA, which consisted of various types of disc prostheses. No meta-analysis has been conducted up to present to compare ACDF with a specialized type of artificial cervical disc. METHODS: We comprehensively searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trails for prospective RCTs that compared BCDA with ACDF. The retrieved results were last updated on October 1, 2015, without language restrictions. We classified the trials into subgroups by short-term and midterm follow-up. RESULTS: Eight relevant RCTs involving 1816 individuals were included in the meta-analysis. In overall-term follow-up, the clinical outcomes indicated that BCDA was superior to ACDF considering lower NDI scores (P = 0.0009), greater range of motion at the index level (P = 0.02), and fewer adverse events (P = 0.004), but inferior to ACDF considering operation time (P < 0.00001). There was no significant difference between two groups regarding blood loss (P = 0.43), length of hospital stay (P = 0.12), and secondary surgical procedures (P = 0.20). CONCLUSION: BCDA presented better NDI improvement, greater range of motion at the index level, and fewer adverse events. However, the benefits of BCDA considering blood loss, length of hospital stay, and secondary surgical procedures are still incapable to be proved. More well design studies with longer term follow-up are needed to provide a better evaluation of the effectiveness and safety of the two procedures. LEVEL OF EVIDENCE: 1.