RESUMEN
Minimally invasive spinal surgery (MISS) for intradural extramedullary (IDEM) spinal tumors is a safe and effective surgical strategy. Currently, various tubular retractors are widely used in the MISS of IDEM spinal tumors, primarily relying on microscopic visualization. To the best of the authors' knowledge, there is no report of pure endoscopic surgery with parallel non-expandable tubular retractors for IDEM spinal lesions. The present study reports a case series of IDEM spinal tumors that were treated via pure endoscopic MISS with a parallel non-expandable tubular retractor. The extent of tumor resection was evaluated by comparing preoperative and postoperative magnetic resonance imaging (MRI). The initial and follow-up clinical conditions were assessed according to the visual analog scale for pain and the modified McCormick scale for neurological status. Postoperative MRI demonstrated that all cases had achieved a gross total resection. After the operation, the clinical symptoms of all patients were significantly improved and there were no serious postoperative complications. At the initial follow-up, the pain experienced by the patients was significantly reduced or had even disappeared, and the neurological deficit was improved by at least one grade on the modified McCormick scale. The present report indicates that pure endoscopic MISS with a parallel non-expandable tubular retractor may be an effective and safe surgical strategy for IDEM spinal tumor resection.
RESUMEN
Spinal cord injury (SCI) is a devastating and common neurological disorder that is difficult to treat. The pain can sustain for many years, making the sufferer extremely painful. Nerve stimulation was first reported half a century ago as a treatment for neuropathic pain. Since then, the method of electrical stimulation through leads placed in the epidural space on the dorsal side of the spinal cord has become a valuable therapeutic tool for SCI. But nerve stimulation equipment is expensive, and the stimulator design and treatment plan are complicated, which hinders its development. In recent years, wearable and implantable triboelectric nanogenerators (TENGs) developed rapidly, and their low cost and safety have brought a new turning point for the development of nerve stimulation. Nanofibrous membrane has been proved that it is a flexible material with the advantages of ultrathin diameter, good connectivity, easy scale-up, tunable wettability, fine flexibility, tunable porosity, controllable composition and so on. In this paper, we discuss the technology of using nanofiber membrane on clothing to create TENGs to provide continuous electrical energy for nerve stimulation to treat SCI in patients by analyzing previous research.
RESUMEN
Remarkably little is known about the physical phenomena leading to nucleation of new perfect crystals within deformed metals during annealing, in particular how and where volumes with nearly perfect lattices evolve from structures filled with dislocations, and how local variations at the micrometer length scale affect this nucleation process. We present here the first experimental measurements that relate directly nucleation of recrystallization to the local deformation microstructure in the bulk of a sample of cold rolled aluminum, further deformed locally by a hardness indentation. White beam differential aperture X-ray microscopy is used for the measurements, allowing us to map a selected gauge volume in the bulk of the sample in the deformed state, then anneal the sample and map the exact same gauge volume in the annealed state. It is found that nuclei develop at sites of high stored energy and they have crystallographic orientations from those present in the deformed state. Accordingly we suggest that for each nucleus the embryonic volume arises from a structural element contained within the voxels identified with the same orientation. Possible nucleation mechanisms are discussed and the growth potentials of the nuclei are also analyzed and discussed.
