Biomechanical assessment of unilateral pedicle screws plus contralateral transfacetopedicular screws after transforaminal lumbar interbody fusion with two cages.

OBJECTIVE: To assess the biomechanical stability of unilateral pedicle screws (UPS) plus contralateral transfacetopedicular screws (TFPS) after transforaminal lumbar interbody fusion (TLIF) with two cages. METHODS: Range of motion (ROM) testing was performed in 28 fresh-frozen human cadaveric lumbar spine motion segments. The sequential test configurations included supplemental constructs after TLIF such as UPS, UPS plus contralateral TFPS and bilateral pedicle screws (BPS). All test specimens were fixated in the normal lordotic lignment, then mounted in a three-dimensional (3-D) motion testing machine and fixed to the load frame of a six degrees of freedom spine simulator. Each of the test constructs were subjected to three load-unload cycles in each of the physiologic planes generating flexion-extension, right-left lateral bending and right-left axial rotation load-displacement curves. Statistical analysis was performed on the ROM data. Comparison of data was performed by repeated-measures analysis of variance for independent samples followed by Bonferroni analysis for multiple comparison procedures. RESULTS: The ROMs for UPS, BPS and UPS plus TFPS fixation after TLIF were significantly smaller than those of the intact spine in all modes. The ROM for UPS plus TFPS fixation was between the largest for UPS and the smallest for BPS. The differences between ROMs of UPS and UPS plus TFPS were significant for both lateral bending and rotation. There were no significant differences between BPS and UPS plus TFPS in any mode. CONCLUSION: Because the UPS construct provides the least stability, especially during lateral bending and rotation, it should be used prudently. After TLIF with two cages, UPS plus TFPS provides stability comparable to that of TLIF with BPS. It is thus an acceptable option in minimally invasive surgery.

[Antitumor effect of calcium phosphate cement incorporating doxorubicin microspheres].

OBJECTIVE: To investigate the antitumor effect of calcium phosphate cement incorporated with doxorubicin microspheres. METHODS: The absorbance at 490 nm of SaoS-2 cells cultured for 5 days in the media containing the extract of the cement incorporating doxorubicin microspheres was measured using Cell Counting Kit-8. SaoS-2 cells were adjusted to the density of 2x10(7) ml(-1) and injected into the left buttock of nude mouse in the volume of 0.2 ml. The cell suspension (0.1 ml) mixed with an equal volume of the cement extract were injected into the right buttock and on the back of the bilateral ears of nude mice. At 12 days after the cell injection, the tumor tissues were obtained and weighed to calculate the tumor inhibition rate, and the pathological samples were observed with HE staining. RESULTS: The extract of the bone cement containing doxorubicin microspheres showed inhibitory effects on the tumor growth in a dose-dependent manner. The tumor inhibition rate reached 61.0% in high-dose group. Tumor necrosis was found in high dose group, but virtually absent in low-dose group. CONCLUSIONS: CPC containing doxorubicin PLGA microspheres can inhibit tumor cell growth both in vitro and in vivo.