Cobalt chromium-Titanium rods versus Titanium-Titanium rods for treatment of adolescent idiopathic scoliosis; which type of rod has better postoperative outcomes?

SUMMARY OBJECTIVE; Compare the outcome of spinal deformity correction between Ti-Ti and CrCo-Ti rods for the treatment of spinal Adolescent Idiopathic Scoliosis (AIS) using rods mentioned with all pedicle screws and translation technique. METHOD; 59 patients operated for spinal deformity (Lenke 1 or 2) AIS. The patients were divided into two groups by random allocation using Ti-Ti rods (n = 29) and CrCo-Ti rods (n = 30) and the alone difference among them in the surgical procedure was rod material (Ti-Ti or CrCo-Ti rods) and finally, radiological outcomes were compared preoperatively, postoperatively and at last follow-up for 12 months. RESULTS; Patients' main curve correction after surgical procedure regardless type of rod was 48.95±11.04 (13-75) degree. Success rate of spinal deformity correction following surgical procedure regardless of type of administered rod was 86.76 ± 11.30 percent (62.5-100%). Mean of deformity correction rate was 91.49±10.67% using CrCo-Ti rods versus 81.86±9.88% using Ti-Ti rods (P-value=0.01). Angle change was 3.29±6.60 for kyphosis angle and 0.59±7.76 for lordosis angle. Rate of main curve correction was not significantly different considering patients' gender (P-value0.657). Main curve correction success rate was in association with patients' age and type of rod (P-value=0.054, r=-1.863 and P-value=0.001, r=8.865 respectively). CONCLUSION; CrCo-Ti rods have the ability to produce higher correction rates in AIS compared to Ti-Ti rod of the same diameter. CrCo-Ti rods provide significant and stable spinal correction, especially in correction of main curve. This rate was associated with patients' age and type of rod administered but not gender.

RESUMO OBJETIVO: Comparar o resultado da correção da deformidade da coluna vertebral com ligas de Ti-Ti e CrCo-Ti para o tratamento da Escoliose Idiopática do Adolescente (EIA) na coluna usando as ligas mencionadas com todos os parafusos pediculares e técnica de tradução. MÉTODO: 59 pacientes operados por EIA com deformidade da coluna vertebral (Lenke 1 ou 2). Os pacientes foram divididos em dois grupos por alocação aleatória usando ligas de Ti-Ti (n = 29) e ligas de CrCo-Ti (n = 30) e a única diferença entre eles no procedimento cirúrgico foi o material da liga (ligas de Ti-Ti ou CrCo-Ti) e, finalmente, resultados radiológicos foram comparados no pré-operatório, pós-operatório e no último retorno por 12 meses. RESULTADOS: A correção da curva principal do paciente após o procedimento cirúrgico, independentemente do tipo de liga, foi de 48,95±11,04 (13-75) graus. A taxa de sucesso da correção da deformidade da coluna vertebral após o procedimento cirúrgico, independentemente do tipo de liga administrada, foi de 86,76 ± 11,30% (62,5-100%). A média da taxa de correção da deformidade foi de 91,49±10,67% usando ligas de CrCo-Ti e 81,86±9,88% usando ligas de Ti-Ti (valor de P = 0,01). A mudança de ângulo foi de 3,29±6,60 para o ângulo de cifose e de 0,59±7,76 para o ângulo de lordose. A taxa de correção da curva principal não foi significativamente diferente considerando o sexo dos pacientes (Valor de P 0,657). A taxa de sucesso da correção da curva principal foi associada à idade do paciente e ao tipo de liga (valor de P=0,054, r=-1,863 e valor de P=0,001, r=8,865, respectivamente). CONCLUSÃO: As ligas de CrCo-Ti têm a capacidade de produzir taxas de correção mais altas em EIA em comparação com a liga de Ti-Ti do mesmo diâmetro. As ligas de CrCo-Ti fornecem uma correção espinhal significativa e estável, especialmente na correção da curva principal. Essa taxa foi associada à idade e ao tipo de liga administrada, mas não ao sexo.

comparative evaluation for soluble intracellular adhesion molecule-1, CEA and CA19-9 in serum of colon and gastric cancer patients

From adhesion molecule receptors on the surface of cancer cells, the carcinoembryonic antigen [CEA], carbohydrate antigen 19-9 [CA19-9] and Intercellular adhesion molecules-1 [ICAM-1] have utilized as molecule markers in some cancers including gastrointestinal malignancy. The limitation and the value of either of these, still need more sought for evaluation of the tumor progression. A group of 53 patients with either colon or gastric cancer selected for operation and 23 healthy matched individuals were selected as control. Their blood was taken before and after operation, and the proteins markers concentration was evaluated using radio-immunoassay technique. The histopathological procedures were performed on surgically removed samples and pathological features were correlated with the protein serum levels. The mean +/- std. serum concentrations of gastric and colon serum samples were designed for CEA 54.4 +/- 23 and 53 +/- 22.6 micro g/l, for CA19-9 81 +/- 56 U/ml and 76 +/- 47, and for sICAM-1 701 +/- 189 and 761 +/- 205 ng/ml respectively. The levels of these markers decrease by a range from 14.5%- 47% three months after operation. In patient groups the levels of ICAM-1, CA19-9 and CEA augmented by 4, 5 and 10 folds respectively. The patients with tumors, which were diagnosed with well-differentiated grade, had a higher level of slCAM-1 than the tumors with moderate or poor differentiation. The similar finding was however not confirmed between CEA, CA19-9 and tumor grade. A clinical value of sICAM-1 as a tumor marker with more advantages than CA19-9 and at least similar with CEA in colon and gastric cancer would be conclusive