RESUMEN
High accuracy in intraoperative computed tomography (iCT) navigation utilizing an intraoperatively acquired dataset for screw placement in the spine has been reported in the literature. To further improve the accuracy and counteract any intraoperative movement of predefined registration points, we introduce an iCT point-to-point navigation, where marker screws are inserted intraoperatively to increase patient safety. In all, 1054 patients who underwent iCT point-to-point navigation for lateral mass and pedicle screw placement were retrospectively analyzed between 09/2005 and 09/2016. Implant-related complications such as screw misplacement, screw loosening, and revision rate were determined. Furthermore, we investigated the rate of complications and the clinical outcome. In total, 6059 screws were inserted in 1054 patients. There were 553 (52.5%) female and 501 (47.5%) male patients. Average age was 63.5 years, mean BMI 27.5 (SD 13.9). Here, 1427 (23.5%) screws were inserted in the cervical, 995 (16.4%) in the thoracic, 3167 (52.3%) in the lumbar, and 470 (7.8%) in the sacral spine. Eight patients required a revision procedure for screw misplacement (0.8%). Total screw misplacement rate was 0.3% (16/6059). With the use of reference markers in iCT-based, spinal, point-to-point navigation, we achieved a high accuracy of screw placement with a low revision rate (0.8%) and a total screw misplacement rate of 0.3%.
Asunto(s)
Tornillos Pediculares/efectos adversos , Complicaciones Posoperatorias/epidemiología , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Enfermedades de la Columna Vertebral/cirugía , Cirugía Asistida por Computador/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Seguridad del Paciente , Reoperación , Estudios Retrospectivos , Cirugía Asistida por Computador/instrumentación , Tomografía Computarizada por Rayos X , Adulto JovenAsunto(s)
Transportador de Casetes de Unión a ATP, Subfamilia G, Miembro 2/genética , Sustitución de Aminoácidos , Antígenos de Grupos Sanguíneos/genética , Exones/genética , Mutación Missense , Proteínas de Neoplasias/genética , Mutación Puntual , Alelos , Prueba de Coombs , Enfermedades en Gemelos/genética , Femenino , Genotipo , Humanos , Masculino , Linaje , Fenotipo , Análisis de Secuencia de ADNAsunto(s)
Anticuerpos/inmunología , Eritroblastosis Fetal/etiología , Sistema del Grupo Sanguíneo de Kell/genética , Adulto , Eritroblastosis Fetal/genética , Eritroblastosis Fetal/inmunología , Exones/genética , Femenino , Humanos , Sistema del Grupo Sanguíneo de Kell/inmunología , Masculino , LinajeRESUMEN
The KEL (ISBT 006), JR (ISBT 032), and LAN (ISBT 033) blood group systems are defined by a complex genetics with a large number of exons, and numerous gene variants. In order to sequence the 53 coding exons and flanking intron regions of all three blood group genes we developed a next-generation-sequencing method using 454-sequencing™ on a Genome Sequencer (GS) Junior™ system. Multiplex analysis of eight individual DNA samples was achieved using molecular identifiers.
Asunto(s)
Antígenos de Grupos Sanguíneos/genética , Técnicas de Genotipaje/métodos , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Análisis de Secuencia de ADN/métodos , Humanos , Sistema del Grupo Sanguíneo de Kell/genética , Desnaturalización de Ácido Nucleico , Reacción en Cadena de la Polimerasa/métodos , Estudios de Validación como AsuntoRESUMEN
BACKGROUND: The SMIM1 protein carries the Vel blood group antigen, and homozygosity for a 17 bp deletion in the coding region of the SMIM1 gene represents the molecular basis of the Vel- blood group phenotype. We developed PCR-based methods for typing the SMIM1 17 bp (64-80del) gene deletion and performed a molecular screening for the Vel- blood type in German blood donors. METHODS: For SMIM1 genotyping, TaqMan-PCR and PCR-SSP methods were developed and validated using reference samples. Both methods were used for screening of donors with blood group O from southwestern Germany. Heterozygotes and homozygotes for the SMIM1 64-80del allele were serologically typed for the Vel blood group antigen. In addition, the rs1175550 SNP in SMIM1 was typed and correlated to the results of the phenotyping. RESULTS: Both genotyping methods, TaqMan-PCR and PCR-SSP, represent reliable methods for the detection of the SMIM1 64-80del allele. Screening of 10,598 blood group O donors revealed 5 individuals homozygous for the deletional allele. They were confirmed Vel- by serological typing. Heterozygotes for the 64-80del allele showed different antigen expressions ranging from very weak to regular positive. CONCLUSION: Molecular screening of blood donors for the Vel- blood type is feasible and avoids the limitations of serological typing which might show false-negative results with heterozygous individuals. The identification of Vel- blood donors significantly contributes to the adequate blood supply of patients with anti-Vel.
