Comparison of 2-year follow-up results of the hybrid surgery using Mobi-C combined with ROI-C and anterior cervical discectomy and fusion for the treatment of contiguous two-level cervical degenerative disc diseases.

Although the Mobi-C artificial disc and the ROI-C cervical cage have been widely used in the treatment of cervical degenerative disc diseases (CDDD), few reports addressed the features of combined application of both devices. This study is aimed at comparing the clinical and radiological outcomes of treating contiguous two-level CDDD using Mobi-C and ROI-C combined in a hybrid surgery (HS) with anterior cervical discectomy and fusion (ACDF) using ROI-C. We reviewed ninety-one patients who underwent HS (n = 48) or ACDF (n = 43) surgery for symptomatic contiguous two-level CDDD. >2 years' clinical and radiological outcomes were reviewed and evaluated retrospectively. At the last follow-up, significant improvement in the mean VAS, JOA, and NDI scores was found both in the HS and ACDF groups (p < 0.05), while the differences between groups were not significant (p > 0.05). The global range of motion (ROM) in the HS group was significantly larger than that in the ACDF group (p < 0.05). The local lordosis improved significantly after surgery in all patients (p < 0.05). Bone resorption and heterotopic ossification (HO) were found after surgery. The result showed that, for the selected patients, HS may provide an alternative approach for the treatment of contiguous two-level CDDD. HS also offers the benefit of both greater global ROM and greater ROM at the Mobi-C index level. Some degree of bone resorption may be an integral component in the early stage of bony fusion in the cage index level. Further studies and long-term follow-up are still needed.

Dynamic Fusion Process in the Anterior Cervical Discectomy and Fusion with Self-Locking Stand-Alone Cages.

BACKGROUND: Self-locking stand-alone cages can achieve satisfactory clinical results and fusion rate. However, there have been no reports on the causes and relationship of different fusion state. This study is to classify the different fusion states of the index level and to explore the potential contributing factors and links of them. METHODS: From June 2008 to October 2011, 42 patients underwent anterior cervical discectomy and fusion with MC+ cages. More than 5 years' follow-up was reviewed. The fusion state and the relevant clinical and radiologic records were reviewed retrospectively. RESULTS: At the last follow-up, the fusion proportion of type I, II, III, and IV was 11.7%, 16.9%, 26.9%, and 42.9%, respectively. The overall fusion rate was 97.4%. For all the fused types, significant improvement for the visual analog scale, Japanese Orthopaedic Association, and Neck Disability Index scores was found at the last follow-up (P < 0.05). However, there were no significant differences between the 4 types (P > 0.05). For sagittal vertical axis, type IV was significantly larger than that of type I, II, and III (P < 0.05), and for range of motion, type III was significantly larger than that of type II and IV (P < 0.05). CONCLUSIONS: For anterior cervical discectomy and fusion with self-locking stand-alone cages, the fusion of the index level seems to be a progressive dynamic process during the mid-term follow-up, which may be influenced by the location of the cage, the aagittal vertical axis of the index level, and the global range of motion of the cervical spine. Satisfactory clinical results could be achieved by all the fused types.

[Application of perfusion bone cement screw in lumbar degenerative disease with osteoporosis].

OBJECTIVE: To observe the early clinical effect of perfusion bone cement screw for lumbar degenerative diseases with osteoporosis. METHODS: The clinical data of 28 patients with lumbar degenerative diseases combined with moderate to severe osteoporosis treated by posterior lateral graft fusion with perfusion of bone cement screws from June 2015 to June 2017 were retrospectively analyzed. There were 9 males and 19 females, aged from 55 to 86 years old with an average of 76 years. Anteroposterior, oblique, and dynamic radiography were performed before operation, and the diagnosis was confirmed by CT, MRI and dual energy X-ray absorptionmetry(DXA). All the patients had moderate to severe lumbar spinal stenosis, including 16 cases with degenerative scoliosis, 12 cases with degenerative lumbar spondylolisthesis, and 16 cases with lumbar disc herniation. According to Jikei grade of osteoporosis, 9 cases were grade II and 19 cases were grade III. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were used to assess the improvement of lumbar leg pain, and neurological function. Imaging data were used to observe the circumstance of pedicle loosening, prolapse, breakage and bone cement leakage, and comprehensively evaluate the fusion. RESULTS: The hospital stay was from 10 to 14 days with an average of 12 days; the operative time was 100 to 150 min with an average of 120 min;the blood loss was 200 to 600 ml with an average of 350 ml (for operations more than 3 vertebral segments, blood filtration recovery was intraoperatively used);the postoperative drainage volume was 150 to 600 ml with an average of 300 ml, no allogeneic blood was used in all the patients. Bone cement of 2 to 3 ml were injected into each vertebral body, and bone cement leakage occurred in 2 cases during injection, both of which were paravertebral vessel leakage, and there was no evidence of intravertebral leakage. The injection of bone cement was terminated in a timely manner without serious complications such as nerve injury, bone cement toxicity, and vascular embolization and pulmonary embolism. According to the fusion criteria by X-ray, 18 cases achieved strong bone fusion, and 10 cases were inaccurate fusion, but no pseudarthrosis occurred in the fusion segment. No screw loosening, prolapse or fracture were found, and postoperative VAS, JOA scores were significantly improved. CONCLUSIONS: Perfusion bone cement screw technique can obtain satisfactory effect in treating lumbar degenerative diseases with osteoporosis.

Rapid determination of 88 veterinary drug residues in milk using automated TurborFlow online clean-up mode coupled to liquid chromatography-tandem mass spectrometry.

A novel method based on TurborFlow online solid phase extraction (SPE) combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) has been established for simultaneous screening and confirmation of 88 wide-range veterinary drugs belonging to eight families (20 sulfonamides, 7 macrolides, 15 quinolones, 8 penicillins, 13 benzimidazoles, 4 tetracyclines, 2 sedatives, and 19 hormones) in milk. The preparation method consists of sample dilution and ultrasonic extraction, followed by an automated turbulent flow cyclone chromatography sample clean-up system. The detection was achieved in selected reaction monitoring mode (SRM). The total run time was within 39 min, including automated extraction, analytical chromatography and re-equilibration of the turboflow system. The optimization of different experimental parameters including extraction, purification, separation, and detection were evaluated separately in this study. The developed method was validated and good performing characteristics were obtained. The linear regression coefficients (R(2)) of matrix-match calibration standard curves established for quantification were higher than 0.9930. The limits of detection (LOD) were in the range of 0.2-2.0 µg/kg given by signal-noise ratio ≥3 (S/N) and the limits of quantification (LOQ, S/N≥10) ranged between 0.5 µg/kg and 10 µg/kg. Average recoveries of spiked target compounds with different levels were between 63.1% and 117.4%, with percentage relative standard deviations (RSD) in the range of 3.3-17.6%. The results indicated that the developed method has great potential for the routine laboratory analysis of large numbers of samples on measuring different classes of compounds. In comparison to traditional procedures, the automated sample clean-up ensures rapid, effective, sensitive analyses of veterinary drugs in milk.

Simultaneous determination of 13 aminoglycoside residues in foods of animal origin by liquid chromatography-electrospray ionization tandem mass spectrometry with two consecutive solid-phase extraction steps.

A confirmatory and quantitative method based on liquid chromatography-electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) has been developed for simultaneous determination of 13 aminoglycoside antibiotics in various samples. The aminoglycoside analytes were released and extracted from different matrices with 5% trichloroacetic acid. The influence of pH values on the solid-phase exaction (SPE) procedure has been studied. Due to different pK(a) values of the compounds, seven aminoglycosides (AGs) were quantitatively retained on Oasis HLB cartridges at pH<1 and then six aminoglycosides were retained at pH 8.5. Thus, the combination of two HLB SPE cartridges with different pH values was involved to simultaneously purify 13 aminoglycosides. The proposed two SPE steps produced high recovery yields for every aminoglycoside in five different matrices. The LC-MS/MS method was validated according to the European Union Commission directive 2002/657/EC. Good performance characteristics were obtained for recovery, precision, calibration curve, stability, specificity, decision limits (CCalpha) and detection capabilities (CCbeta) in different matrices. The optimized procedure has been successfully applied to real samples in our laboratories (n> or =200) for 1 year. It demonstrated that the new method was robust and useful for identification and quantification of 13 aminoglycosides residues in foods of animal origin.