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Sample records for fusion techniques transforaminal

  1. True Percutaneous Transforaminal Lumbar Interbody Fusion: Case Illustrations, Surgical Technique, and Limitations.

    PubMed

    Syed, Hasan; Voyadzis, Jean-Marc

    2016-07-01

    Objective The last decade has seen significant advances in minimally invasive techniques for lumbar interbody fusion that have reduced approach-related morbidity. Percutaneous lumbar interbody fusion involves a posterior transforaminal approach to the disk space with a minimal access port through the Kambin triangle. This technique obviates the need for the facetectomy or laminectomy required in a traditional transforaminal approach. This article describes the surgical technique, potential advantages and limitations, and representative case illustrations. Methods Percutaneous transforaminal interbody fusion was performed on two patients with axial back and leg pain as a result of degenerative disk disease. Diskectomy and interbody cage insertion were completed through a tubular dilator placed onto the disk space in the Kambin triangle. Posterior fixation was achieved with percutaneous transfacet screws. Clinical outcome and postoperative complications are discussed. Results Both patients demonstrated significant clinical improvement after surgery with > 1 year follow-up despite experiencing transient neurologic symptoms. Conclusion Although this report demonstrates the feasibility and advantages of the approach, the technique is limited by the potential for nerve root injury and pseudoarthrosis. PMID:26291889

  2. Improvement of Segmental Lordosis in Transforaminal Lumbar Interbody Fusion: A Comparison of Two Techniques

    PubMed Central

    Rice, James W.; Sedney, Cara L.; Daffner, Scott D.; Arner, Justin W.; Emery, Sanford E.; France, John C.

    2015-01-01

    Study Design Retrospective review. Objective The purpose of this study was to determine the radiographic impact of a transforaminal lumbar interbody fusion (TLIF) versus a cantilever TLIF technique on segmental lordosis, segmental coronal alignment, and disk height. Methods A retrospective review was done of all patients undergoing TLIF procedures from 2006 to 2011 by three spine surgeons. Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed. Results One hundred one patients were included in the study. Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p > 0.0001). Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes. PMID:27099813

  3. Improvement of Segmental Lordosis in Transforaminal Lumbar Interbody Fusion: A Comparison of Two Techniques.

    PubMed

    Rice, James W; Sedney, Cara L; Daffner, Scott D; Arner, Justin W; Emery, Sanford E; France, John C

    2016-05-01

    Study Design Retrospective review. Objective The purpose of this study was to determine the radiographic impact of a transforaminal lumbar interbody fusion (TLIF) versus a cantilever TLIF technique on segmental lordosis, segmental coronal alignment, and disk height. Methods A retrospective review was done of all patients undergoing TLIF procedures from 2006 to 2011 by three spine surgeons. Traditional TLIF versus cantilever TLIF results were compared, and radiographic outcomes were assessed. Results One hundred one patients were included in the study. Patients undergoing the cantilever TLIF procedure had a significantly greater change in segmental lordosis and disk height compared with those who underwent the traditional procedure (p > 0.0001). Conclusions The cantilever TLIF technique can lead to greater change in segmental lordosis based upon radiographic outcomes. PMID:27099813

  4. Minimally Invasive Transforaminal Lumbar Interbody Fusion.

    PubMed

    Ahn, Junyoung; Tabaraee, Ehsan; Singh, Kern

    2015-07-01

    Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is performed via tubular dilators thereby preserving the integrity of the paraspinal musculature. The decreased soft tissue disruption in the MIS technique has been associated with significantly decreased blood loss, shorter length of hospitalization, and an expedited return to work while maintaining comparable arthrodesis rates when compared with the open technique particularly in the setting of spondylolisthesis (isthmic and degenerative), recurrent symptomatic disk herniation, spinal stenosis, pseudoarthrosis, iatrogenic instability, and spinal trauma. The purpose of this article and the accompanying video wass to demonstrate the techniques for a primary, single-level MIS TLIF. PMID:26079840

  5. Minimally invasive transforaminal lumbosacral interbody fusion.

    PubMed

    Chang, Peng-Yuan; Wang, Michael Y

    2016-07-01

    In minimally invasive spinal fusion surgery, transforaminal lumbar (sacral) interbody fusion (TLIF) is one of the most common procedures that provides both anterior and posterior column support without retraction or violation to the neural structure. Direct and indirect decompression can be done through this single approach. Preoperative plain radiographs and MR scan should be carefully evaluated. This video demonstrates a standard approach for how to perform a minimally invasive transforaminal lumbosacral interbody fusion. The video can be found here: https://youtu.be/bhEeafKJ370 . PMID:27364426

  6. Successful salvage surgery for failed transforaminal lumbosacral interbody fusion using the anterior transperitoneal approach.

    PubMed

    Hozumi, Takashi; Orita, Sumihisa; Inage, Kazuhide; Fujimoto, Kazuki; Sato, Jun; Shiga, Yasuhiro; Kanamoto, Hirohito; Abe, Koki; Yamauchi, Kazuyo; Aoki, Yasuchika; Nakamura, Junichi; Matsuura, Yusuke; Suzuki, Takane; Takahashi, Kazuhisa; Ohtori, Seiji; Sainoh, Takeshi

    2016-05-01

    Transforaminal lumbar interbody fusion (TLIF) is a popular posterior spinal fusion technique, but sometimes require salvage surgery when implant failure occurs, which involves possible neural damage due to postoperative adhesion. The current report deals with successful anterior transperitoneal salvage surgery for failed L5-S TLIF with less neural invasiveness. PMID:27190611

  7. Transforaminal Approach in Thoracal Disc Pathologies: Transforaminal Microdiscectomy Technique

    PubMed Central

    Dalbayrak, Sedat; Öztürk, Kadir; Yılmaz, Mesut; Gökdağ, Mahmut; Ayten, Murat

    2014-01-01

    Objective. Many surgical approaches have been defined and implemented in the last few decades for thoracic disc herniations. The endoscopic foraminal approach in foraminal, lateral, and far lateral disc hernias is a contemporary minimal invasive approach. This study was performed to show that the approach is possible using the microscope without an endoscope, and even the intervention on the discs within the spinal canal is possible by having access through the foramen. Methods. Forty-two cases with disc hernias in the medial of the pedicle were included in this study; surgeries were performed with transforaminal approach and microsurgically. Extraforaminal disc hernias were not included in the study. Access was made through the Kambin triangle, foramen was enlarged, and spinal canal was entered. Results. The procedure took 65 minutes in the average, and the mean bleeding amount was about 100cc. They were mobilized within the same day postoperatively. No complications were seen. Follow-up periods range between 5 and 84 months, and the mean follow-up period is 30.2 months. Conclusion. Transforaminal microdiscectomy is a method that can be performed in any clinic with standard spinal surgery equipment. It does not require additional equipment or high costs. PMID:24839557

  8. Modified Mini-open Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Pakzaban, Peyman

    2016-01-01

    Study Design. Retrospective case series. Objective. To describe a modified technique for mini-open transforaminal lumbar interbody fusion (TLIF) that improves visualization for decompression, fusion, and freehand pedicle screw insertion. Accuracy of freehand pedicle screw placement with this technique was assessed. Summary of Background Data. Mini-open TLIF is a minimally invasive technique that allows limited visualization of the bone and neural anatomy via an expandable tubular retractor inserted through the Wiltse plane. No significant modification that of this technique has been described in detail. Methods. In this study, 92 consecutive patients underwent one-level modified mini-open TLIF (MOTLIF). MOTLIF modifications consisted of (i) transmuscular dissection through the multifidus muscle rather than intermuscular dissection in the Wiltse plane; (ii) microsurgical detachment of multifidus from the facet rather than muscle dilation; (iii) en bloc total facetectomy (unilateral or bilateral, as needed for decompression); (iv) facet autograft used for interbody fusion; and (v) solid pedicle screws placed bilaterally by a freehand technique under direct vision. Results. The mean age was 53 years. Mean follow-up was 35 months (minimum 2 yrs). By 6 months, mean Visual Analog Scale for back and leg pain had improved from 51 to 19 and from 58 to 17, respectively, and mean Oswestry Disability Index (ODI) improved from 53 to 16. These improvements persisted at 2 years. Solid fusion, defined by computed tomography at 1 year, was achieved in 88.1%, whereas satisfactory fusion was achieved in 95.2% of patients. Pedicle screws were accurately placed in 335 of 336 imaged pedicles (pedicle breach grades: 91.1% grade 1; 8.6% grade 2; and 0.3% grade 3). Mean fluoroscopy time was 29.3 seconds. Conclusion. MOTLIF is a safe and effective minimally invasive technique with a high fusion rate. It allows accurate pedicle screw placement by a freehand technique. By eliminating bi

  9. Minimally invasive transforaminal lumbar interbody fusion with percutaneous navigated guidewireless lumbosacral pedicle screw fixation.

    PubMed

    Chen, Kevin S; Park, Paul

    2016-07-01

    This video details the minimally invasive approach for treatment of a symptomatic Grade II lytic spondylolisthesis with high-grade foraminal stenosis. In this procedure, the use of a navigated, guidewireless technique for percutaneous pedicle screw placement at the lumbosacral junction is highlighted following initial decompression and transforaminal interbody fusion. Key steps of the procedure are delineated that include positioning, exposure, technique for interbody fusion, intraoperative image acquisition, and use of a concise 2-step process for navigated screw placement without using guidewires. The video can be found here: https://youtu.be/2u6H4Pc_8To . PMID:27364422

  10. Comparison between Minimally Invasive Transforaminal Lumbar Interbody Fusion and Conventional Open Transforaminal Lumbar Interbody Fusion: An Updated Meta-analysis

    PubMed Central

    Xie, Lei; Wu, Wen-Jian; Liang, Yu

    2016-01-01

    Background: The previous studies agree that minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has better function outcomes, less blood loss, and shorter hospital stay, when compared to open-TLIF. However, there are no significance differences on operative time, complication, and reoperation rate between the two procedures. This could be from less relative literatures and lower grade evidence. The further meta-analysis is needed with more and higher grade evidences to compare the above two TLIF procedures. Methods: Prospective and retrospective studies that compared open-TLIF and MIS-TLIF were identified by searching the Medline, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP database (the literature search comprised Medical Subject Heading terms and key words or Emtree term). The retrieval time ranged from the date when the database was founded to January 2015. Pooled risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals were calculated for the clinical outcomes and perioperative data. Results: Twenty-four studies (n = 1967 patients) were included in this review (n = 951, open-TLIF, n = 1016, MIS-TLIF). MIS-TLIF was associated with a significant decrease in the visual analog score (VAS)-back pain score (WMD = −0.44; P = 0.001), Oswestry Disabilities Index (WMD = −1.57; P = 0.005), early ambulation (WMD = −1.77; P = 0.0001), less blood loss (WMD = −265.59; P < 0.00001), and a shorter hospital stay (WMD = −1.89; P < 0.0001). However, there were no significant differences in the fusion rate (RR = 0.99; P = 0.34), VAS-leg pain (WMD = −0.10; P = 0.26), complication rate (RR = 0.84; P = 0.35), operation time (WMD = −5.23; P = 0.82), or reoperation rate (RR = 0.73; P = 0.32). Conclusions: MIS-TLIF resulted in a similar fusion rate with better functional outcome, less blood loss, shorter ambulation, and hospital stay; furthermore, it did not increase the complication or

  11. Accidental Durotomy in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Frequency, Risk Factors, and Management

    PubMed Central

    Volz, Florian; Krüger, Marie T.; Kogias, Evangelos; Rölz, Roland; Sircar, Ronen; Hubbe, Ulrich

    2015-01-01

    Purpose. To assess the frequency, risk factors, and management of accidental durotomy in minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Methods. This single-center study retrospectively investigates 372 patients who underwent MIS TLIF and were mobilized within 24 hours after surgery. The frequency of accidental durotomies, intraoperative closure technique, body mass index, and history of previous surgery was recorded. Results. We identified 32 accidental durotomies in 514 MIS TLIF levels (6.2%). Analysis showed a statistically significant relation of accidental durotomies to overweight patients (body mass index ≥25 kg/m2; P = 0.0493). Patient age older than 65 years tended to be a positive predictor for accidental durotomies (P = 0.0657). Mobilizing patients on the first postoperative day, we observed no durotomy-associated complications. Conclusions. The frequency of accidental durotomies in MIS TLIF is low, with overweight being a risk factor for accidental durotomies. The minimally invasive approach seems to minimize durotomy-associated complications (CSF leakage, pseudomeningocele) because of the limited dead space in the soft tissue. Patients with accidental durotomy can usually be mobilized within 24 hours after MIS TLIF without increased risk. The minimally invasive TLIF technique might thus be beneficial in the prevention of postoperative immobilization-associated complications such as venous thromboembolism. This trial is registered with DRKS00006135. PMID:26075294

  12. Transforaminal Lumbar Interbody Fusion for Management of Recurrent Lumbar Disc Herniation

    PubMed Central

    2016-01-01

    Study Design Retrospective study. Purpose To study the surgical outcome of transforaminal lumbar interbody fusion (TLIF) combined with trans-pedicular screws fixation for management of selected cases of recurrent lumbar disc herniation. Overview of Literature Recurrent lumbar disc herniation is a major cause of surgical failure, occurring in 5%–11% of cases. The optimal technique for treatment is controversial. Some authors believe that repeated simple discectomy is the treatment of choice, but approach-related complications can be considerable. Other surgeons prefer more removal of posterior elements (as lamina and facet joints) with posterior fusion. Methods The study included 15 patients who presented with symptomatic recurrent lumbar disc herniation who underwent reoperation through posterior trans-pedicular screws and TLIF in our department from April 2008 to May 2010, with a 24-month follow-up. Japanese Orthopedic Association Scale (JOA) was used for low back pain. The results of surgery were also evaluated with the MacNab classification. Results The mean JOA score showed significant improvement, increasing from 9.5 before surgery to 24.0 at the end of follow-up (p<0.001). Clinical outcome was excellent in 7 patients (46% of cases), good in 6 patients (40%) and fair in only 2 patients (14%). There was a significant difference (p<0.05) between patients presenting with recurrent disc at the ipsilateral side and those at the contralateral side. Conclusions In spite of the small number of patients and the short follow-up period, the good clinical and radiological outcome achieved in this study encourage the belief that TLIF is an effective option for the treatment of selected cases of recurrent lumbar disc herniation. PMID:26949458

  13. Incidence of graft extrusion following minimally invasive transforaminal lumbar interbody fusion.

    PubMed

    Bakhsheshian, Joshua; Khanna, Ryan; Choy, Winward; Lawton, Cort D; Nixon, Alex T; Wong, Albert P; Koski, Tyler R; Liu, John C; Song, John K; Dahdaleh, Nader S; Smith, Zachary A; Fessler, Richard G

    2016-02-01

    Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has been scrutinized for having a complex learning curve. Careful assessment of MI-TLIF complications and critical analyses of prevention may aid a safe adoption of this technique. The current report focuses on the incidence of interbody cage extrusions following MI-TLIF in a series of 513 patients. The authors discuss their experience with graft extrusions and provide methods to minimize this complication. This study retrospectively reviewed 513 prospectively followed patients who underwent MI-TLIF over a 10 year period. The inclusion criteria consisted of all patients who underwent one to three level MI-TLIF, from whom the incidence of cage extrusion was analyzed. Cage extrusion was defined as an interbody graft migrating outside the cephalad and caudal vertebral body posterior margin. Cage extrusions were diagnosed by comparing the intraoperative radiographs to the postoperative radiographs. Patients with >10° coronal curves, significant sagittal malalignment, infection, and preoperative instrumentation failure were excluded. Of 513 patients undergoing MI-TLIF, five patients (0.97%) were diagnosed with cage migrations. The mean follow-up duration was 13.6 ± standard deviation of 8.8 months. Complications included asymptomatic cage migration alone (two patients) neurological decline (two patients) and epidural hematoma (one patient). On average, cage migrations cost a university hospital an additional $US17,217 for revision treatment. While the incidence of cage migrations is low (0.97%), it can lead to postoperative complications that require revision surgery and increased hospital costs. The risk for this significant complication can be minimized with proper technique and patient selection. PMID:26578209

  14. Comparison of the efficacy of transforaminal and interlaminar radicular block techniques for treating lumbar disk hernia☆

    PubMed Central

    Rezende, Rodrigo; Jacob Júnior, Charbel; da Silva, Camila Kill; de Barcellos Zanon, Igor; Cardoso, Igor Machado; Batista Júnior, José Lucas

    2015-01-01

    Objective To compare the interlaminar and transforaminal block techniques with regard to the state of pain and presence or absence of complications. Method This was a randomized double-blind prospective study of descriptive and comparative nature, on 40 patients of both sexes who presented lumbar sciatic pain due to central-lateral or foraminal disk hernias. The patients had failed to respond to 20 physiotherapy sessions, but did not present instability, as diagnosed in dynamic radiographic examinations. The type of block to be used was determined by means of a draw: transforaminal (group 1; 20 patients) or interlaminar (group 2; 20 patients). Results Forty patients were evaluated (17 males), with a mean age of 49 years. There was a significant improvement in the state of pain in all patients who underwent radicular block using both techniques, although the transforaminal technique presented better results than the interlaminar technique. Conclusion Both techniques were effective for pain relief and presented low complication rates, but the transforaminal technique was more effective than the interlaminar technique. PMID:26229920

  15. A Biomechanical Comparison of Shape Design and Positioning of Transforaminal Lumbar Interbody Fusion Cages

    PubMed Central

    Comer, Garet C.; Behn, Anthony; Ravi, Shashank; Cheng, Ivan

    2015-01-01

    Study Design  Cadaveric biomechanical analysis. Objective  The aim of this study was to compare three interbody cage shapes and their position within the interbody space with regards to construct stability for transforaminal lumbar interbody fusion. Methods  Twenty L2–L3 and L4–L5 lumbar motion segments from fresh cadavers were potted in polymethyl methacrylate and subjected to testing with a materials testing machine before and after unilateral facetectomy, diskectomy, and interbody cage insertion. The three cage types were kidney-shaped, articulated, and straight bullet-shaped. Each cage type was placed in a common anatomic area within the interbody space before testing: kidney, center; kidney, anterior; articulated, center; articulated, anterior; bullet, center; bullet, lateral. Load-deformation curves were generated for axial compression, flexion, extension, right bending, left bending, right torsion, and left torsion. Finally, load to failure was tested. Results  For all applied loads, there was a statistically significant decrease in the slope of the load-displacement curves for instrumented specimens compared with the intact state (p < 0.05) with the exception of right axial torsion (p = 0.062). Among all instrumented groups, there was no statistically significant difference in stiffness for any of the loading conditions or load to failure. Conclusions  Our results failed to show a clearly superior cage shape design or location within the interbody space for use in transforaminal lumbar interbody fusion. PMID:27433426

  16. Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disorders: Mini-open TLIF and Corrective TLIF

    PubMed Central

    HARA, Masahito; NISHIMURA, Yusuke; NAKAJIMA, Yasuhiro; UMEBAYASHI, Daisuke; TAKEMOTO, Masaya; YAMAMOTO, Yuu; HAIMOTO, Shoichi

    Minimally invasive transforaminal lumbar interbody fusion (TLIF) as a short fusion is widely accepted among the spine surgeons. However in the long fusion for degenerative kyphoscoliosis, corrective spinal fixation by an open method is thought to be frequently selected. Our objective is to study whether the mini-open TLIF and corrective TLIF contribute to the improvement of the spinal segmental and global alignment. We divided the patients who performed lumbar fixation surgery into three groups. Group 1 (G1) consisted of mini-open TLIF procedures without complication. Group 2 (G2) consisted of corrective TLIF without complication. Group 3 (G3) consisted of corrective TLIF with instrumentation-related complication postoperatively. In all groups, the lumbar lordosis (LL) highly correlated with developing surgical complications. LL significantly changed postoperatively in all groups, but was not corrected in the normal range in G3. There were statistically significant differences in preoperative and postoperative LL and mean difference between the pelvic incidence (PI) and LL between G3 and other groups. The most important thing not to cause the instrumentation-related failure is proper correction of the sagittal balance. In the cases with minimal sagittal imbalance with or without coronal imbalance, short fusion by mini-open TLIF or long fusion by corrective TLIF contributes to good clinical results if the lesion is short or easily correctable. However, if the patients have apparent sagittal imbalance with or without coronal imbalance, we should perform proper correction of the sagittal spinal alignment introducing various technologies. PMID:26119895

  17. Single-level transforaminal interbody fusion for traumatic lumbosacral fracture-dislocation: a case report.

    PubMed

    Herrera, Anthony J; Berry, Chirag A; Rao, Raj D

    2013-02-01

    L5S1 fracture-dislocations are rare three-column injuries. The infrequency of this injury has led to a lack of a universally accepted treatment strategy. Transforaminal lumbar interbody fusion (TLIF) has been shown to be an effective approach for interbody fusion in degenerative indications, but has not been previously reported in the operative management of traumatic lumbosacral dislocation. The authors report a case of traumatic L5S1 fracture-dislocation in a 30-year-old male, presenting with a right-sided L5 neurologic deficit, following a street sweeper accident. Imaging revealed an L5S1 fracture-dislocation with fracture of the S1 body. Open reduction with TLIF and L5S1 posterolateral instrumented fusion was carried out within 24 hours of injury. Excellent reduction was obtained, and maintained at long-term follow-up, with complete resolution of pain and neurologic deficit. In this patient, L5S1 fracture-dislocation was treated successfully, with an excellent outcome, with a single level TLIF and instrumented posterolateral fusion at L5S1. PMID:23547528

  18. Application of transforaminal lumbar interbody fusion in old thoracolumbar fracture and dislocation

    PubMed Central

    Fang, Xiangqian; Fan, Shunwu; Zhao, Xing

    2011-01-01

    Background The main indications for surgery for old thoracolumbar fractures are pain, progressive deformity, neurological damage, or increasing neurological deficit. These fractures have been one of the greatest therapeutic challenges in spinal surgery. Anterior, posterior, or combined anterior and posterior procedures have been successful to some extent. As far as we know, there is no report in the literature of transforaminal lumbar interbody fusion (TLIF) for old thoracolumbar fracture and dislocation. Methods Case report. Results A 26-year-old man with old fracture and dislocation of T12/L1 was treated with TLIF. At 12 months' follow-up, multi-slice computed tomography (CT) scans showed that solid fusion had been achieved between T12 and L1. Back pain had resolved completely at 2-year follow-up. Conclusions We performed TLIF for in a man with old fracture and dislocation of T12/L1, with good clinical outcome. TLIF might be an option in the treatment of old thoracolumbar fracture. PMID:22330118

  19. Clinical and radiological outcome of anterior-posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients.

    PubMed

    Faundez, Antonio A; Schwender, James D; Safriel, Yair; Gilbert, Thomas J; Mehbod, Amir A; Denis, Francis; Transfeldt, Ensor E; Wroblewski, Jill M

    2009-02-01

    Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine. Only those with one or two-level surgeries were included. Clinical chart and radiologic reviews were done, fusion solidity assessed, and functional outcomes determined by pre- and postoperative SF-36 and postoperative Oswestry Disability Index (ODI), and a satisfaction questionnaire. The minimum follow-up was 24 months. The mean operating room time and hospital length of stay were less in the TLIF group. The blood loss was slightly less in the TLIF group (409 vs. 480 cc.). Intra-operative complications were higher in the APF group, mostly due to vein lacerations in the anterior retroperitoneal approach. Postoperative complications were higher in the TLIF group due to graft material extruding against the nerve root or wound drainage. The pseudarthrosis rate was statistically equal (APF 17.6% and TLIF 23.1%) and was higher than most published reports. Significant improvements were noted in both groups for the SF-36 questionnaires. The mean ODI scores at follow-up were 33.5 for the APF and 39.5 for the TLIF group. The patient satisfaction rate was equal for the two groups. PMID:19125304

  20. Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients

    PubMed Central

    Schwender, James D.; Safriel, Yair; Gilbert, Thomas J.; Mehbod, Amir A.; Denis, Francis; Transfeldt, Ensor E.; Wroblewski, Jill M.

    2009-01-01

    Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine. Only those with one or two-level surgeries were included. Clinical chart and radiologic reviews were done, fusion solidity assessed, and functional outcomes determined by pre- and postoperative SF-36 and postoperative Oswestry Disability Index (ODI), and a satisfaction questionnaire. The minimum follow-up was 24 months. The mean operating room time and hospital length of stay were less in the TLIF group. The blood loss was slightly less in the TLIF group (409 vs. 480 cc.). Intra-operative complications were higher in the APF group, mostly due to vein lacerations in the anterior retroperitoneal approach. Postoperative complications were higher in the TLIF group due to graft material extruding against the nerve root or wound drainage. The pseudarthrosis rate was statistically equal (APF 17.6% and TLIF 23.1%) and was higher than most published reports. Significant improvements were noted in both groups for the SF-36 questionnaires. The mean ODI scores at follow-up were 33.5 for the APF and 39.5 for the TLIF group. The patient satisfaction rate was equal for the two groups. PMID:19125304

  1. Modeled cost-effectiveness of transforaminal lumbar interbody fusion compared with posterolateral fusion for spondylolisthesis using N(2)QOD data.

    PubMed

    Carreon, Leah Y; Glassman, Steven D; Ghogawala, Zoher; Mummaneni, Praveen V; McGirt, Matthew J; Asher, Anthony L

    2016-06-01

    OBJECTIVE Transforaminal lumbar interbody fusion (TLIF) has become the most commonly used fusion technique for lumbar degenerative disorders. This suggests an expectation of better clinical outcomes with this technique, but this has not been validated consistently. How surgical variables and choice of health utility measures drive the cost-effectiveness of TLIF relative to posterolateral fusion (PSF) has not been established. The authors used health utility values derived from Short Form-6D (SF-6D) and EQ-5D and different cost-effectiveness thresholds to evaluate the relative cost-effectiveness of TLIF compared with PSF. METHODS From the National Neurosurgery Quality and Outcomes Database (N(2)QOD), 101 patients with spondylolisthesis who underwent PSF were propensity matched to patients who underwent TLIF. Health-related quality of life measures and perioperative parameters were compared. Because health utility values derived from the SF-6D and EQ-5D questionnaires have been shown to vary in patients with low-back pain, quality-adjusted life years (QALYs) were derived from both measures. On the basis of these matched cases, a sensitivity analysis for the relative cost per QALY of TLIF versus PSF was performed in a series of cost-assumption models. RESULTS Operative time, blood loss, hospital stay, and 30-day and 90-day readmission rates were similar for the TLIF and PSF groups. Both TLIF and PSF significantly improved back and leg pain, Oswestry Disability Index (ODI) scores, and EQ-5D and SF-6D scores at 3 and 12 months postoperatively. At 12 months postoperatively, patients who had undergone TLIF had greater improvements in mean ODI scores (30.4 vs 21.1, p = 0.001) and mean SF-6D scores (0.16 vs 0.11, p = 0.001) but similar improvements in mean EQ-5D scores (0.25 vs 0.22, p = 0.415) as patients treated with PSF. At a cost per QALY threshold of $100,000 and using SF-6D-based QALYs, the authors found that TLIF would be cost-prohibitive compared with PSF at a

  2. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion.

    PubMed

    Lian, Xiaofeng; Navarro-Ramirez, Rodrigo; Berlin, Connor; Jada, Ajit; Moriguchi, Yu; Zhang, Qiwei; Härtl, Roger

    2016-01-01

    Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years). We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. "Total navigation" (complete intraoperative 3D navigation without fluoroscopy) can be achieved by combining Airo navigation with navigated guide tubes for screw placement. PMID:27529069

  3. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Lian, Xiaofeng; Berlin, Connor; Moriguchi, Yu; Zhang, Qiwei; Härtl, Roger

    2016-01-01

    Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years). We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. “Total navigation” (complete intraoperative 3D navigation without fluoroscopy) can be achieved by combining Airo navigation with navigated guide tubes for screw placement. PMID:27529069

  4. Open and Minimally Invasive Transforaminal Lumbar Interbody Fusion: Comparison of Intermediate Results and Complications

    PubMed Central

    Hee, Hwan Tak

    2015-01-01

    Study Design Prospective study. Purpose To compare clinical and radiological outcomes of open vs. minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). Overview of Literature MI-TLIF promises smaller incisions and less soft tissue dissection resulting in lower morbidity and faster recovery; however, it is technically challenging. Methods Twenty-five patients with MI-TLIF were compared with 25 matched open TLIF controls. A minimum 2 year follow-up and a statistical analysis of perioperative and long-term outcomes were performed. Potential complications were recorded. Results The mean ages for the open and MI-TLIF cases were 44.4 years (range, 19-69 years) and 43.6 years (range, 20-69 years), respectively. The male:female ratio was 13:12 for both groups. Average follow-up was 26.9 months for the MI-TLIF group and 29.3 months for the open group. Operative duration was significantly longer in the MI-TLIF group than that in the open group (p<0.05). No differences in estimated blood loss, duration to ambulation, or length of stay were found. Significant improvements in the Oswestry disability index and EQ-5D functional scores were observed at 6-, 12-, and 24-months in both groups, but no significant difference was detected between the groups. Fusion rates were comparable. Cage sizes were significantly smaller in the MI-TLIF group at the L5/S1 level (p<0.05). One patient had residual spinal stenosis at the MI-TLIF level, and one patient who underwent two-level MI-TLIF developed a deep vein thrombosis resulting in a pulmonary embolism. Conclusions MI-TLIF and open TLIF had comparable long-term benefits. Due to technical constraints, patients should be advised on the longer operative time and potential undersizing of cages at the L5S1 level. PMID:25901228

  5. Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

    PubMed Central

    Kleiner, Jeffrey B; Kleiner, Hannah M; Grimberg, E John; Throlson, Stefanie J

    2016-01-01

    Study design Disk material removed (DMR) during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF) surgery was compared to the corresponding bone graft (BG) volumes inserted at the time of fusion. A novel BG delivery tool (BGDT) was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD). This study was performed prospectively. Summary of background data Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk relative to AD. PMID:27274320

  6. Outcome Measures of an Intracanal, Endoscopic Transforaminal Decompression Technique: Initial Findings from the MIS Prospective Registry

    PubMed Central

    Sclafani, Joseph A.; Raiszadeh, Kamshad; Laich, Dan; Shen, Jian; Bennett, Matthew; Blok, Robert; Liang, Kevin

    2015-01-01

    Background Minimally invasive transforaminal endoscopic procedures can achieve spinal decompression through either direct or indirect techniques. Subtle variations in trajectory of the surgical corridor can dictate access to the pathologic tissue. Two general strategies exist: the intradiscal “inside-out” technique and the extradiscal, intracanal (IC) technique. The IC technique utilizes a more lateral transforaminal approach than the intradiscal technique, which allows for a more direct decompression of the spinal canal. Objective This study is an assessment of IC patient outcome data obtained through analysis of a previously validated MIS Prospective Registry. Methods Post-hoc analysis was performed on the MIS Prospective Registry database containing 1032 patients. A subgroup of patients treated with the endoscopic IC technique was identified. Patient outcome measures after treatment of symptomatic disk herniation and neuroforaminal stenosis were evaluated. Results A total of 86 IC patients were analyzed. Overall, there was significant improvement in employment and walking tolerance as soon as 6 weeks post-op as well as significant one year VAS and ODI score improvement. Subanalysis of IC patients with two distinct primary diagnoses was performed. Group IC-1 (disc herniation) showed improvement in ODI and VAS back and leg outcomes at 1 year post-op. Group IC-2 (foraminal stenosis) showed VAS back and leg score improvement at one year post-op but did not demonstrate significant improvement in overall ODI outcome at any time point. The one year re-operation rate was 2% (1/40) for group IC-1 and 28% (5/18) for group IC-2. Conclusions The initial results of the MIS Registry IC subgroup show a significant clinical improvement when the technique is employed to treat patients with lumbar disc herniation. The treatment of foraminal stenosis can lead to improved short-term clinical outcome but is associated with a high re-operation rate at 1 year post-op. PMID

  7. Long-Term Objective Physical Activity Measurements using a Wireless Accelerometer Following Minimally Invasive Transforaminal Interbody Fusion Surgery

    PubMed Central

    Mobbs, Ralph J.

    2016-01-01

    We report on a case of a patient who underwent minimally invasive transforaminal lumbar interbody fusion (mi-TLIF) with objective physical activity measurements performed preoperatively and postoperatively at up to 12-months using wireless accelerometer technology. In the first postoperative month following surgery, the patient had reduced mobility, taking 2,397 steps over a distance of 1.8 km per day. However, the number of steps taken and distance travelled per day had returned to baseline levels by the second postoperative month. At one-year follow-up, the patient averaged 5,095 steps per day in the month over a distance of 3.8 km; this was a 60% improvement in both steps taken and distance travelled compared to the preoperative status. The use of wireless accelerometers is feasible in obtaining objective physical activity measurements before and after lumbar interbody fusion and may be applicable to other related spinal surgeries as well. PMID:27114781

  8. A Randomized Controlled Trial Comparing Transforaminal Lumbar Interbody Fusion and Uninstrumented Posterolateral Fusion in the Degenerative Lumbar Spine.

    PubMed

    Jalalpour, Kourosh; Neumann, Pavel; Johansson, Christer; Hedlund, Rune

    2015-08-01

    Study Design Randomized controlled trial. Objective Despite a large number of publications of outcomes after spinal fusion surgery, there is still no consensus on the efficacy of the several different fusion methods. The aim of this study was to determine whether transforaminal lumbar interbody fusion (TLIF) results in an improved clinical outcome compared with uninstrumented posterolateral fusion (PLF) in the surgical treatment for chronic low back pain. Methods This study included 135 patients with degenerative disk disease (n = 96) or postdiskectomy syndrome (n = 39). Inclusion criteria were at least 1 year of back pain with or without leg pain in patients aged 20 to 65 with one- or two-level disease. Exclusion criteria were sequestration of disk hernia, psychosocial instability, isthmic spondylolisthesis, drug abuse, and previous spine surgery other than diskectomy. Pain was assessed by visual analog scale (pain index). Functional disability was quantified by the disability rating index and Oswestry Disability Index. The global outcome was assessed by the patient and classified as much better, better, unchanged, or worse. The patients were randomized to conventional uninstrumented PLF (n = 67) or TLIF (n = 68). PLF was performed in a standardized fashion using autograft. TLIF was performed with pedicle titanium screw fixation and a porous tantalum interbody spacer with interbody and posterolateral autograft. The clinical outcome measurements were obtained preoperatively and at 12 and 24 months postoperatively. The 2-year follow-up rate was 98%. Results The two treatment groups improved significantly from preoperatively to 2 years' follow-up. At final follow-up, the results in the TLIF group were significantly superior to those in the PLF group in pain index (2.0 versus 3.9, p = 0.007) and in disability rating index (22 versus 36, p = 0.003). The Oswestry Disability Index was better in the TLIF group (20 versus 28, p = 0

  9. Posterolateral instrumented fusion with and without transforaminal lumbar interbody fusion for the treatment of adult isthmic spondylolisthesis: A randomized clinical trial with 2-year follow-up

    PubMed Central

    Etemadifar, Mohammad Reza; Hadi, Abdollah; Masouleh, Mehran Feizi

    2016-01-01

    Background: Spondylolisthesis is a common cause of surgery in patients with lower back pain. Although posterolateral fusion and pedicle screw fixation are a relatively common treatment method for the treatment of spondylolisthesis, controversy exists about the necessity of adding interbody fusion to posterolateral fusion. The aim of our study was to assess the functional disability, pain, and complications in patients with spondylolisthesis treated by posterolateral instrumented fusion (PLF) with and without transforaminal lumbar interbody fusion (TLIF) in a randomized clinical trial. Materials and Methods: From February 2007 to February 2011, 50 adult patients with spondylolisthesis were randomly assigned to be treated with PLF or PLF+TLIF techniques (25 patients in each group) by a single surgeon. Back pain, leg pain, and disability were assessed before treatment and until 2 years after surgical treatment using visual analog scale (VAS) and oswestry disability index (ODI). Patients were also evaluated for postoperative complications such as infection, neurological complications, and instrument failure. Results: All patients completed the 24 months of follow-up. Twenty patients were females and 30 were males. Average age of the patients was 53 ± 11 years for the PLF group and 51 ± 13 for the PLF + TLIF group. Back pain, leg pain, and disability score were significantly improved postoperatively compared to preoperative scores (P < 0.001). At 3 months of follow-up, there was no statistically significant difference in VAS score for back pain and leg pain in both groups; however, after 6 months and 1 year and 2 years follow-up, the reported scores for back pain and leg pain were significantly lower in the PLF+TLIF group (P < 0.05). The ODI score was also significantly lower in the PLF+TLIF group at 1 year and 2 years of follow-up (P < 0.05). One screw breakage and one superficial infection occurred in the PLF+TLIF group, which had no statistical significance (P = 0

  10. The anatomic rationale for transforaminal endoscopic interbody fusion: a cadaveric analysis.

    PubMed

    Hardenbrook, Mitchell; Lombardo, Sergio; Wilson, Miles C; Telfeian, Albert E

    2016-02-01

    OBJECTIVE The authors describe a cadaveric analysis to determine the ideal dimensions and trajectory for considering endoscopic transforaminal interbody implantation. METHODS The soft tissues of 8 human cadavers were removed from L-1 to the sacrum, exposing the posterior bony elements. Facetectomies were performed bilaterally at each lumbar level with resection of the pars interarticularis, revealing the pedicles, nerve roots, and interbody disc space. Each level was digitally photographed with a marker for scale and evaluated with digital analysis software. The traversing and exiting nerve roots and pedicle margins were identified, and the distances between these structures and their relationships to the surrounding structures were documented. RESULTS The dimensions of 2 areas were measured: the working triangle and safe zone. The working triangle is the triangle between the exiting and traversing nerve roots above the superior margin of the inferior pedicle. The safe zone is the trapezoid bounded by the widths of the superior and inferior pedicles between the exiting and traversing nerve roots. The mean surface area for the working triangle was 1.83 cm(2), with L5-S1 having the largest area at 2.19 cm(2). The mean surface area of the safe zone was 1.19 cm(2), with L5-S1 having the largest area at 1.26 cm(2). At the medial border of the pedicle extending superiorly, there were no nerve structures within 1.19 cm at any level. On the lateral border of the pedicle, the exiting nerve root was closer superiorly, with the closest being 0.3 cm. CONCLUSIONS The working triangle is a relatively large area. The safe zone, just superior to the pedicle, is free of nerve structures. By utilizing the superior border of the pedicle, the disc space can be accessed within this safe zone without risk of injury to the nerves. A thorough understanding of foraminal anatomy is fundamental for considering how to safely access the disc space, thereby utilizing less invasive endoscopic

  11. Postoperative Cyst Associated with Bone Morphogenetic Protein Use in Posterior and Transforaminal Lumbar Interbody Fusion Managed Conservatively: Report of Two Cases

    PubMed Central

    Mejía, Diana M; Drazin, Doniel; Anand, Neel

    2016-01-01

    Bone morphogenetic protein use in spinal surgery for off-label indications continues to remain popular. One area where its use has known associated radicular complications is posterior or transforaminal lumbar interbody fusion. These complications include radiculitis, cyst development, and heterotopic ossification, amongst others. Typically, cyst development has been treated surgically. We present two cases of bone morphogenetic protein-related cysts treated medically and thus, present medical treatment as an alternative treatment option. PMID:27014519

  12. Minimally Invasive Transforaminal Lumbar Interbody Fusion at L5-S1 through a Unilateral Approach: Technical Feasibility and Outcomes

    PubMed Central

    Choi, Won-Suh; Kim, Jin-Sung; Ryu, Kyeong-Sik; Hur, Jung-Woo; Seong, Ji-Hoon

    2016-01-01

    Background. Minimally invasive spinal transforaminal lumbar interbody fusion (MIS-TLIF) at L5-S1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. Objective. To determine the clinical and radiological outcomes of MIS-TLIF for treatment of single-level spinal stenosis low-grade isthmic or degenerative spondylolisthesis at L5-S1. Methods. Radiological data and electronic medical records of patients who underwent MIS-TLIF between May 2012 and December 2014 were reviewed. Fusion rate, cage position, disc height (DH), disc angle (DA), disc slope angle, segmental lordotic angle (SLA), lumbar lordotic angle (LLA), and pelvic parameters were assessed. For functional assessment, the visual analogue scale (VAS), Oswestry disability index (ODI), and patient satisfaction rate (PSR) were utilized. Results. A total of 21 levels in 21 patients were studied. DH, DA, SLA, and LLA had increased from their preoperative measures at the final follow-up. Fusion rate was 86.7% (18/21) at 12 months' follow-up. The most common cage position was anteromedial (15/21). The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up. PSR was 88%. Cage subsidence was observed in 33.3% (7/21). Conclusions. The clinical and radiologic outcomes after MIS-TLIF at L5-S1 in patients with spinal stenosis or spondylolisthesis are generally favorable. PMID:27433472

  13. Finite Element Analysis of a New Pedicle Screw-Plate System for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Zhou, Yue; Li, Changqing; Liu, Huan

    2015-01-01

    Purpose Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is increasingly popular for the surgical treatment of degenerative lumbar disc diseases. The constructs intended for segmental stability are varied in MI-TLIF. We adopted finite element (FE) analysis to compare the stability after different construct fixations using interbody cage with posterior pedicle screw-rod or pedicle screw-plate instrumentation system. Methods A L3–S1 FE model was modified to simulate decompression and fusion at L4–L5 segment. Fixation modes included unilateral plate (UP), unilateral rod (UR), bilateral plate (BP), bilateral rod (BR) and UP+UR fixation. The inferior surface of the S1 vertebra remained immobilized throughout the load simulation, and a bending moment of 7.5 Nm with 400N pre-load was applied on the L3 vertebra to recreate flexion, extension, lateral bending, and axial rotation. Range of motion (ROM) and Von Mises stress were evaluated for intact and instrumentation models in all loading planes. Results All reconstructive conditions displayed decreased motion at L4–L5. The pedicle screw-plate system offered equal ROM to pedicle screw-rod system in unilateral or bilateral fixation modes respectively. Pedicle screw stresses for plate system were 2.2 times greater than those for rod system in left lateral bending under unilateral fixation. Stresses for plate were 3.1 times greater than those for rod in right axial rotation under bilateral fixation. Stresses on intervertebral graft for plate system were similar to rod system in unilateral and bilateral fixation modes respectively. Increased ROM and posterior instrumentation stresses were observed in all loading modes with unilateral fixation compared with bilateral fixation in both systems. Conclusions Transforaminal lumbar interbody fusion augmentation with pedicle screw-plate system fixation increases fusion construct stability equally to the pedicle screw-rod system. Increased posterior

  14. Hemothorax caused by the trocar tip of the rod inserter after minimally invasive transforaminal lumbar interbody fusion: case report.

    PubMed

    Maruo, Keishi; Tachibana, Toshiya; Inoue, Shinichi; Arizumi, Fumihiro; Yoshiya, Shinichi

    2016-03-01

    Minimally invasive surgery (MIS) for transforaminal lumbar interbody fusion (MIS-TLIF) is widely used for lumbar degenerative diseases. In the paper the authors report a unique case of a hemothorax caused by the trocar tip of the rod inserter after MIS-TLIF. A 61-year-old woman presented with thigh pain and gait disturbance due to weakness in her lower right extremity. She was diagnosed with a lumbar disc herniation at L1-2 and the MIS-TLIF procedure was performed. Immediately after surgery, the patient's thigh pain resolved and she remained stable with normal vital signs. The next day after surgery, she developed severe anemia and her hemoglobin level decreased to 7.6 g/dl, which required blood transfusions. A chest radiograph revealed a hemothorax. A CT scan confirmed a hematoma of the left paravertebral muscle. A chest tube was placed to treat the hemothorax. After 3 days of drainage, there was no active bleeding. The patient was discharged 14 days after surgery without leg pain or any respiratory problems. This complication may have occurred due to injury of the intercostal artery by the trocar tip of the rod inserter. A hemothorax after spine surgery is a rare complication, especially in the posterior approach. The rod should be caudally inserted in the setting of the thoracolumbar spine. PMID:26588499

  15. Clinical outcomes of single-level lumbar artificial disc replacement compared with transforaminal lumbar interbody fusion in an Asian population

    PubMed Central

    Lee, Wei Ting; Liu, Gabriel; Thambiah, Joseph; Wong, Hee Kit

    2015-01-01

    INTRODUCTION The objective of this study was to examine the clinical outcome of single-level lumbar artificial disc replacement (ADR) compared to that of transforaminal lumbar interbody fusion (TLIF) for the treatment of symptomatic degenerative disc disease (DDD) in an Asian population. METHODS This was a retrospective review of 74 patients who had surgery performed for discogenic lower backs that involved only the L4/5 and L5/S1 levels. All the patients had lumbar DDD without radiculopathy or spondylolithesis, and concordant pain with discogram at the pathological level. The patients were divided into two groups – those who underwent ADR and those who underwent TLIF. RESULTS A trend suggesting that the ADR group had better perioperative outcomes (less blood loss, shorter operating time, shorter hospital stay and shorter time to ambulation) than the TLIF group was observed. However, a trend indicating that surgical-approach-related complications occurred more frequently in the ADR group than the TLIF group was also observed. The rate of revision surgery was comparable between the two groups. CONCLUSION Our findings suggest that for the treatment of discogenic lower back pain, lumbar ADR has better perioperative outcomes and a similar revision rate when compared with TLIF. However, the use of ADR was associated with a higher incidence of surgical-approach-related complications. More studies with bigger cohort sizes and longer follow-up periods are needed to determine the long-term efficacy and safety of ADR in lumbar DDD. PMID:25917472

  16. Impact on Neurological Recovery of Transforaminal Debridement and Interbody Fusion versus Transpedicular Decompression in Combination with Pedicle Screw Instrumentation for Treating Thoracic and Lumbar Spinal Tuberculosis

    PubMed Central

    Choovongkomol, Kongtush; Piyapromdee, Urawit; Leownorasate, Manoon

    2016-01-01

    Study Design Retrospective study. Purpose To compare the neurological outcome of transforaminal debridement and interbody fusion with transpedicular decompression for treatment of thoracic and lumbar spinal tuberculosis. Overview of Literature Few articles have addressed the impact of neurological recovery in patients with tuberculosis who were treated by two different operative methods via the posterior-only approach. Methods Clinical and radiographic results of one-stage posterior instrumented spinal fusion for treatment of tuberculous spondylodiscitis with neurological deficits were reviewed and analyzed from 2009 to 2013. The extensive (E) group consisted of patients who received transforaminal debridement and interbody fusion, whereas transpedicular decompression was performed on limited (L) group. Rapid recovery was improvement of at least one Frankel grade within 6 weeks after operation. Otherwise, it was slow recovery. Results All 39 patients had improved neurological signs. The median follow-up period was 24 months. Proportionately younger patients (under 65 years of age) received extensive surgery (15 of 18, 83.3% vs. 11 of 21, 52.4%; p=0.04). The mean operative time and blood loss in the group E were higher than in the group L (both p<0.01). With regard to type of procedure, especially at thoracic and thoracolumbar spine, patients who underwent extensive surgery had rapid neurological recovery significantly different from those of limited surgery (p=0.01; Relative Risk, 3.06; 95% Confidence Interval, 1.13 to 8.29). Conclusions Transforaminal debridement and interbody fusion provides more rapid neurological recovery in patients with thoracic and thoracolumbar spinal tuberculosis compared to transpedicular decompression. PMID:27340536

  17. Biomechanical Analysis of a Newly Developed Shape Memory Alloy Hook in a Transforaminal Lumbar Interbody Fusion (TLIF) In Vitro Model

    PubMed Central

    Wang, Xi; Xu, Jing; Zhu, Yuexing; Li, Jiukun; Zhou, Si; Tian, Shunliang; Xiang, Yucheng; Liu, Xingmo; Zheng, Ying; Pan, Tao

    2014-01-01

    Objective The objective of this biomechanical study was to evaluate the stability provided by a newly developed shape memory alloy hook (SMAH) in a cadaveric transforaminal lumbar interbody fusion (TLIF) model. Methods Six human cadaveric spines (L1-S2) were tested in an in vitro flexibility experiment by applying pure moments of ±8 Nm in flexion/extension, left/right lateral bending, and left/right axial rotation. After intact testing, a TLIF was performed at L4-5. Each specimen was tested for the following constructs: unilateral SMAH (USMAH); bilateral SMAH (BSMAH); unilateral pedicle screws and rods (UPS); and bilateral pedicle screws and rods (BPS). The L3–L4, L4–L5, and L5-S1 range of motion (ROM) were recorded by a Motion Analysis System. Results Compared to the other constructs, the BPS provided the most stability. The UPS significantly reduced the ROM in extension/flexion and lateral bending; the BSMAH significantly reduced the ROM in extension/flexion, lateral bending, and axial rotation; and the USMAH significantly reduced the ROM in flexion and left lateral bending compared with the intact spine (p<0.05). The USMAH slightly reduced the ROM in extension, right lateral bending and axial rotation (p>0.05). Stability provided by the USMAH compared with the UPS was not significantly different. ROMs of adjacent segments increased in all fixed constructs (p>0.05). Conclusions Bilateral SMAH fixation can achieve immediate stability after L4–5 TLIF in vitro. Further studies are required to determine whether the SMAH can achieve fusion in vivo and alleviate adjacent segment degeneration. PMID:25474112

  18. Surgeons' Exposure to Radiation in Single- and Multi-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion; A Prospective Study

    PubMed Central

    Funao, Haruki; Ishii, Ken; Momoshima, Suketaka; Iwanami, Akio; Hosogane, Naobumi; Watanabe, Kota; Nakamura, Masaya; Toyama, Yoshiaki; Matsumoto, Morio

    2014-01-01

    Although minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has widely been developed in patients with lumbar diseases, surgeons risk exposure to fluoroscopic radiation. However, to date, there is no studies quantifying the effective dose during MIS-TLIF procedure, and the radiation dose distribution is still unclear. In this study, the surgeons' radiation doses at 5 places on the bodies were measured and the effective doses were assessed during 31 consecutive 1- to 3-level MIS-TLIF surgeries. The operating surgeon, assisting surgeon, and radiological technologist wore thermoluminescent dosimeter on the unshielded thyroid, chest, genitals, right middle finger, and on the chest beneath a lead apron. The doses at the lens and the effective doses were also calculated. Mean fluoroscopy times were 38.7, 53.1, and 58.5 seconds for 1, 2, or 3 fusion levels, respectively. The operating surgeon's mean exposures at the lens, thyroid, chest, genitals, finger, and the chest beneath the shield, respectively, were 0.07, 0.07, 0.09, 0.14, 0.32, and 0.05 mSv in 1-level MIS-TLIF; 0.07, 0.08, 0.09, 0.18, 0.34, and 0.05 mSv in 2-level; 0.08, 0.09, 0.14, 0.15, 0.36, and 0.06 mSv in 3-level; and 0.07, 0.08, 0.10, 0.15, 0.33, and 0.05 mSv in all cases. Mean dose at the operating surgeon's right finger was significantly higher than other measurements parts (P<0.001). The operating surgeon's effective doses (0.06, 0.06, and 0.07 mSv for 1, 2, and 3 fusion levels) were low, and didn't differ significantly from those of the assisting surgeon or radiological technologist. Revision MIS-TLIF was not associated with higher surgeons' radiation doses compared to primary MIS-TLIF. There were significantly higher surgeons' radiation doses in over-weight than in normal-weight patients. The surgeons' radiation exposure during MIS-TLIF was within the safe level by the International Commission on Radiological Protection's guidelines. The accumulated radiation exposure, especially to

  19. Percutaneous Transforaminal Lumbar Interbody Fusion (pTLIF) with a Posterolateral Approach for the Treatment of Degenerative Disk Disease: Feasibility and Preliminary Results

    PubMed Central

    Morgenstern, Christian

    2015-01-01

    Background Interbody fusion by open discectomy is the usual treatment for degenerative disk disease but requires a relatively long recovery period. The transforaminal posterolateral approach is a well-known standard in endoscopic spine surgery that allows direct access to the disk with progressive tissue dilation. The aim of this study was to assess the feasibility of percutaneous transforaminal interbody fusion (pTLIF) with insertion of an expandable or a standard rigid interbody implant for patients with degenerative disk disease with or without spondylolisthesis and for revision surgery. Methods Between 2009 and 2014, the pTLIF procedure was performed in 30 patients. Ten patients underwent insertion of a rigid implant (group A) and the remaining 20 underwent insertion of an expandable titanium interbody implant as the initial procedure (n = 10) (group B) or after failed back surgery (n = 10) (group C). Patient outcomes were scored with visual analogic scale (VAS), Oswestry disability index (ODI) and modified Macnab criteria. Results The mean follow-up period was 38 (17) (range 11 to 67) months. The outcome was excellent in 18, good in 10 and fair in 2. No poor results and no major complications were reported. No differences in VAS and ODI scores according to the study group were found. Median postoperative time until hospital discharge was 26 hours (20 to 68 hours). Postoperative values for VAS and ODI scores improved significantly (p<0.05) compared to preoperative data in all study groups. Conclusions These preliminary results have shown the feasibility and efficacy of the pTLIF procedure using a posterolateral approach for the treatment of degenerative disk disease with or without spondylolisthesis up to grade 2 and in revision surgery. No significant differences in outcome were observed between an expandable and a rigid cage. Median postoperative time until hospital discharge was faster compared to standard TLIF (26 hours vs. 9.3 days). PMID:26484004

  20. Efficacy of Transforaminal Endoscopic Spine System (TESSYS) Technique in Treating Lumbar Disc Herniation.

    PubMed

    Pan, Zhimin; Ha, Yoon; Yi, Seong; Cao, Kai

    2016-01-01

    BACKGROUND To compare efficacy and safety of percutaneous transforaminal endoscopic spine system (TESSYS) and traditional fenestration discectomy (FD) in treatment of lumbar disc herniation (LDH). MATERIAL AND METHODS A total of 106 LDH patients were divided into TESSYS group (n=48) and FD group (n=58). Visual analogue scale (VAS), Oswestry disability index (ODI), Japanese Orthopedic Association (JOA), and modified MacNab criteria were used for efficacy evaluation. Post-operative responses were compared by enzyme-linked immunosorbent assay (ELISA) based on detection of serum IL-6, CRP, and CPK levels. RESULTS In the TESSYS group, compared with the FD group, we observed, shorter incision length, less blood loss, shorter hospital stay, lower hospitalization cost, shorter recovery time, lower complication rate (all P<0.001), and lower VAS scores of lumbago and skelalgia at 3 days and 1, 3, and 6 months postoperatively (all P<0.05). At 24 and 48 h postoperatively, CRP level was remarkably higher in the FD group compared to the TESSYS group (P<0.001). Further, comparison of IL-6 levels at 6, 12, 24, and 48 h postoperatively revealed significantly higher levels in the FD group than in the FESSYS group (all P<0.001). CONCLUSIONS TESSYS had clinical advantages over FD and entails less trauma and quicker postoperative recovery, suggesting that TESSYS is well tolerated by patients and is a better approach than FD in surgical treatment of LDH. PMID:26887645

  1. Efficacy of Transforaminal Endoscopic Spine System (TESSYS) Technique in Treating Lumbar Disc Herniation

    PubMed Central

    Pan, Zhimin; Ha, Yoon; Yi, Seong; Cao, Kai

    2016-01-01

    Background To compare efficacy and safety of percutaneous transforaminal endoscopic spine system (TESSYS) and traditional fenestration discectomy (FD) in treatment of lumbar disc herniation (LDH). Material/Methods A total of 106 LDH patients were divided into TESSYS group (n=48) and FD group (n=58). Visual analogue scale (VAS), Oswestry disability index (ODI), Japanese Orthopedic Association (JOA), and modified MacNab criteria were used for efficacy evaluation. Post-operative responses were compared by enzyme-linked immunosorbent assay (ELISA) based on detection of serum IL-6, CRP, and CPK levels. Results In the TESSYS group, compared with the FD group, we observed, shorter incision length, less blood loss, shorter hospital stay, lower hospitalization cost, shorter recovery time, lower complication rate (all P<0.001), and lower VAS scores of lumbago and skelalgia at 3 days and 1, 3, and 6 months postoperatively (all P<0.05). At 24 and 48 h postoperatively, CRP level was remarkably higher in the FD group compared to the TESSYS group (P<0.001). Further, comparison of IL-6 levels at 6, 12, 24, and 48 h postoperatively revealed significantly higher levels in the FD group than in the FESSYS group (all P<0.001). Conclusions TESSYS had clinical advantages over FD and entails less trauma and quicker postoperative recovery, suggesting that TESSYS is well tolerated by patients and is a better approach than FD in surgical treatment of LDH. PMID:26887645

  2. TECHNIQUE, DIFFICULTY, AND ACCURACY OF COMPUTED TOMOGRAPHY-GUIDED TRANSLAMINAR AND TRANSFORAMINAL LUMBOSACRAL EPIDURAL AND INTRAARTICULAR LUMBAR FACET JOINT INJECTIONS IN DOGS.

    PubMed

    Liotta, Annalisa; Sandersen, Charlotte; Couvreur, Thierry; Bolen, Géraldine

    2016-01-01

    In human medicine, spinal pain and radiculopathy are commonly managed by computed tomography (CT)-guided facet joint injections and by transforaminal or translaminar epidural injections. In dogs, CT-guided lumbosacral epidural or lumbar facet joint injections have not been described. The aim of this experimental, ex vivo, feasibility study was to develop techniques and to assess their difficulty and accuracy. Two canine cadavers were used to establish the techniques and eight cadavers to assess difficulty and accuracy. Contrast medium was injected and a CT scan was performed after each injection. Accuracy was assessed according to epidural or joint space contrast opacification. Difficulty was classified as easy, moderately difficult, or difficult, based on the number of CT scans needed to guide insertion of the needle. A total of six translaminar and five transforaminal epidural and 53 joint injections were performed. Translaminar injections had a high success rate (100%), were highly accurate (75%), and easy to perform (100%). Transforaminal injections had an moderately high success rate (75%), were accurate (75%), and moderately difficult to perform (100%). Success rate of facet joint injections was 62% and was higher for larger facet joints, such as L7-S1. Accuracy of facet joint injections ranged from accurate (37-62%) to highly accurate (25%) depending on the volume injected. In 77% of cases, injections were moderately difficult to perform. Possible complications of epidural and facet joint injections were subarachnoid and vertebral venous plexus puncture and periarticular spread, respectively. Further studies are suggested to evaluate in vivo feasibility and safety of these techniques. PMID:26693948

  3. Novel Pedicle Screw and Plate System Provides Superior Stability in Unilateral Fixation for Minimally Invasive Transforaminal Lumbar Interbody Fusion: An In Vitro Biomechanical Study

    PubMed Central

    Zhu, Qingan; Zhou, Yue; Li, Changqing; Liu, Huan; Huang, Zhiping; Shang, Jin

    2015-01-01

    Purpose This study aims to compare the biomechanical properties of the novel pedicle screw and plate system with the traditional rod system in asymmetrical posterior stabilization for minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). We compared the immediate stabilizing effects of fusion segment and the strain distribution on the vertebral body. Methods Seven fresh calf lumbar spines (L3-L6) were tested. Flexion/extension, lateral bending, and axial rotation were induced by pure moments of ± 5.0 Nm and the range of motion (ROM) was recorded. Strain gauges were instrumented at L4 and L5 vertebral body to record the strain distribution under flexion and lateral bending (LB). After intact kinematic analysis, a right sided TLIF was performed at L4-L5. Then each specimen was tested for the following constructs: unilateral pedicle screw and rod (UR); unilateral pedicle screw and plate (UP); UR and transfacet pedicle screw (TFS); UP and TFS; UP and UR. Results All instrumented constructs significantly reduced ROM in all motion compared with the intact specimen, except the UR construct in axial rotation. Unilateral fixation (UR or UP) reduced ROM less compared with the bilateral fixation (UP/UR+TFS, UP+UR). The plate system resulted in more reduction in ROM compared with the rod system, especially in axial rotation. UP construct provided more stability in axial rotation compared with UR construct. The strain distribution on the left and right side of L4 vertebral body was significantly different from UR and UR+TFS construct under flexion motion. The strain distribution on L4 vertebral body was significantly influenced by different fixation constructs. Conclusions The novel plate could provide sufficient segmental stability in axial rotation. The UR construct exhibits weak stability and asymmetrical strain distribution in fusion segment, while the UP construct is a good alternative choice for unilateral posterior fixation of MI-TLIF. PMID:25807513

  4. Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up.

    PubMed

    Wang, Michael Y; Grossman, Jay

    2016-02-01

    OBJECTIVE One of the principal goals of minimally invasive surgery has been to speed postoperative recovery. In this case series, the authors used an endoscopic technique for interbody fusion combined with percutaneous screw fixation to obviate the need for general anesthesia. METHODS The first 10 consecutive patients treated with a minimum of 1 year's follow-up were included in this series. The patients were all treated using endoscopic access through Kambin's triangle to allow for neural decompression, discectomy, endplate preparation, and interbody fusion. This was followed by percutaneous pedicle screw and connecting rod placement using liposomal bupivacaine for long-acting analgesia. No narcotics or regional anesthetics were used during surgery. RESULTS All patients underwent the procedure successfully without conversion to open surgery. The patients' average age was 62.2 ± 9.0 years (range 52-78 years). All patients had severe disc height collapse, and 60% had a Grade I spondylolisthesis. The mean operative time was 113.5 ± 6.3 minutes (range 105-120 minutes), and blood loss was 65 ± 38 ml (range 30-190 ml). The mean length of hospital stay was 1.4 ± 1.3 nights. There were no intraoperative or postoperative complications. Comparison of preoperative and final clinical metrics demonstrated that the Oswestry Disability Index improved from 42 ± 11.8 to 13.3 ± 15.1; the 36-Item Short Form Health Survey (SF-36) Physical Component Summary improved from 47.6 ± 3.8 to 49.7 ± 5.4; the SF-36 Mental Component Summary decreased from 47 ± 3.9 to 46.7 ± 3.4; and the EQ-5D improved from 10.7 ± 9.5 to 14.2 ± 1.6. There were no cases of nonunion identified radiographically on follow-up imaging. CONCLUSIONS Endoscopic fusion under conscious sedation may represent a feasible alternative to traditional lumbar spine fusion in select patients. Larger clinical series are necessary to validate that clinical improvements are sustained and that arthrodesis rates are

  5. Spontaneous slip reduction of low-grade isthmic spondylolisthesis following circumferential release via bilateral minimally invasive transforaminal lumbar interbody fusion: technical note and short-term outcome.

    PubMed

    Pan, Jie; Li, Lijun; Qian, Lie; Zhou, Wei; Tan, Jun; Zou, Le; Yang, Mingjie

    2011-02-15

    STUDY DESIGN.: Retrospective clinical data analysis. OBJECTIVE.: To investigate and verify our philosophy of spontaneous slip reduction following circumferential release via bilateral minimally invasive transforaminal lumbar interbody fusion (Mini-TLIF) for treatment of low-grade symptomatic isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA.: Symptomatic isthmic spondylolisthesis usually requires surgical intervention, and the most currently controversial focus is on method and degree of reduction; and Mini-TLIF is an attractive surgical procedure for isthmic spondylolisthesis. METHODS.: Between February 2004 and June 2008, 21 patients with low-grade isthmic spondylolisthesis underwent Mini-TLIF in our institute. Total resection of the scar around the pars interarticularis liberated the nerve roots, achieving posterior release as well. The disc was thoroughly resected, and the disc space was gradually distracted and thoroughly released with sequential disc shavers until rupture of anulus conjunct with anterior longitudinal ligament, accomplishing anterior release, so as to insert Cages. Because of circumferential release, the slipped vertebrae would tend to obtain spontaneous reduction, and with pedicle screw fixation, additional reduction would be achieved without any application of posterior translation force. Radiographs, Visual Analogue Scale, and Oswestry Disability Index were documented. All the cases were followed up for 10 to 26 months. RESULTS.: Slip percentage was reduced from 24.2% ± 6.9% to 10.5% ± 4.0%, and foraminal area percentage increased from 89.1% ± 3.0% to 93.6% ± 2.1%. Visual Analogue Scale and Oswestry Disability Index decreased from 7.8 ± 1.5 to 2.1 ± 1.1 and from 53.3 ± 16.2 to 17.0 ± 7.8, respectively. No neurologic complications were encountered. There were no signs of instrumentation failure. The fusion rate approached 100%. CONCLUSION.: Slip reduction is based on circumferential release. The procedure can be well performed

  6. Biomechanical comparison of unilateral and bilateral pedicle screws fixation for transforaminal lumbar interbody fusion after decompressive surgery -- a finite element analysis

    PubMed Central

    2012-01-01

    Background Little is known about the biomechanical effectiveness of transforaminal lumbar interbody fusion (TLIF) cages in different positioning and various posterior implants used after decompressive surgery. The use of the various implants will induce the kinematic and mechanical changes in range of motion (ROM) and stresses at the surgical and adjacent segments. Unilateral pedicle screw with or without supplementary facet screw fixation in the minimally invasive TLIF procedure has not been ascertained to provide adequate stability without the need to expose on the contralateral side. This study used finite element (FE) models to investigate biomechanical differences in ROM and stress on the neighboring structures after TLIF cages insertion in conjunction with posterior fixation. Methods A validated finite-element (FE) model of L1-S1 was established to implant three types of cages (TLIF with a single moon-shaped cage in the anterior or middle portion of vertebral bodies, and TLIF with a left diagonally placed ogival-shaped cage) from the left L4-5 level after unilateral decompressive surgery. Further, the effects of unilateral versus bilateral pedicle screw fixation (UPSF vs. BPSF) in each TLIF cage model was compared to analyze parameters, including stresses and ROM on the neighboring annulus, cage-vertebral interface and pedicle screws. Results All the TLIF cages positioned with BPSF showed similar ROM (<5%) at surgical and adjacent levels, except TLIF with an anterior cage in flexion (61% lower) and TLIF with a left diagonal cage in left lateral bending (33% lower) at surgical level. On the other hand, the TLIF cage models with left UPSF showed varying changes of ROM and annulus stress in extension, right lateral bending and right axial rotation at surgical level. In particular, the TLIF model with a diagonal cage, UPSF, and contralateral facet screw fixation stabilize segmental motion of the surgical level mostly in extension and contralaterally axial

  7. Screw Placement Accuracy for Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery: A Study on 3-D Neuronavigation-Guided Surgery

    PubMed Central

    Torres, Jorge; James, Andrew R.; Alimi, Marjan; Tsiouris, Apostolos John; Geannette, Christian; Härtl, Roger

    2012-01-01

    Purpose The aim of this study was to assess the impact of 3-D navigation for pedicle screw placement accuracy in minimally invasive transverse lumbar interbody fusion (MIS-TLIF). Methods A retrospective review of 52 patients who had MIS-TLIF assisted with 3D navigation is presented. Clinical outcomes were assessed with the Oswestry Disability Index (ODI), Visual Analog Scales (VAS), and MacNab scores. Radiographic outcomes were assessed using X-rays and thin-slice computed tomography. Result The mean age was 56.5 years, and 172 screws were implanted with 16 pedicle breaches (91.0% accuracy rate). Radiographic fusion rate at a mean follow-up of 15.6 months was 87.23%. No revision surgeries were required. The mean improvement in the VAS back pain, VAS leg pain, and ODI at 11.3 months follow-up was 4.3, 4.5, and 26.8 points, respectively. At last follow-up the mean postoperative disc height gain was 4.92 mm and the mean postoperative disc angle gain was 2.79 degrees. At L5–S1 level, there was a significant correlation between a greater disc space height gain and a lower VAS leg score. Conclusion Our data support that application of 3-D navigation in MIS-TLIF is associated with a high level of accuracy in the pedicle screw placement. PMID:24353961

  8. Clinical outcomes of two types of cages used in transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases: n-HA/PA66 cages versus PEEK cages.

    PubMed

    Deng, Qian-xing; Ou, Yun-sheng; Zhu, Yong; Zhao, Zeng-hui; Liu, Bo; Huang, Qiu; Du, Xing; Jiang, Dian-ming

    2016-06-01

    This study reports the clinical effects of nano-hydroxyapatite/polyamide66 cages (n-HA/PA66 cages) and compares the clinical outcomes between n-HA/PA66 and polyetheretherketone cages (PEEK cages) for application in transforaminal lumbar interbody fusion (TLIF). A retrospective and case-control study involving 124 patients using n-HA/PA66 cages and 142 patients using PEEK cages was conducted. All patients underwent TLIF and had an average of 2-years of follow-up. The Oswestry Disability Index and Visual Analog Scale were selected to assess the pain of low back and leg, as well as neurological status. The intervertebral space height and segmental angle were also measured to estimate the radiological changes. At the 1-year and final follow-ups, the fusion and subsidence rates were evaluated. There was no significant difference between the two groups regarding clinical and radiological results. At the final follow-up, the bony fusion rate was 92.45 and 91.57 % for the n-HA/PA66 and PEEK groups, respectively, and the subsidence rate was 7.55 and 8.99 %, respectively. The study indicated that both n-HA/PA66 and PEEK cages could promote effective clinical and radiographic outcomes when used to treat degenerative lumbar diseases. The high fusion and low subsidence rates revealed that n-HA/PA66 cages could be an alternative ideal choice as the same to PEEK cages for lumbar reconstruction after TLIF. PMID:27091044

  9. Combined transforaminal lumbar interbody fusion with posterolateral instrumented fusion for degenerative disc disease can be a safe and effective treatment for lower back pain

    PubMed Central

    Deukmedjian, Ara J; Cianciabella, Augusto J; Cutright, Jason; Deukmedjian, Arias

    2015-01-01

    Background: Lumbar fusion is a proven treatment for chronic lower back pain (LBP) in the setting of symptomatic spondylolisthesis and degenerative scoliosis; however, fusion is controversial when the primary diagnosis is degenerative disc disease (DDD). Our objective was to evaluate the safety and effectiveness of lumbar fusion in the treatment of LBP due to DDD. Materials and Methods: Two-hundred and five consecutive patients with single or multi-level DDD underwent lumbar decompression and instrumented fusion for the treatment of chronic LBP between the years of 2008 and 2011. The primary outcome measures in this study were back and leg pain visual analogue scale (VAS), patient reported % resolution of preoperative back pain and leg pain, reoperation rate, perioperative complications, blood loss and hospital length of stay (LOS). Results: The average resolution of preoperative back pain per patient was 84% (n = 205) while the average resolution of preoperative leg pain was 90% (n = 190) while a mean follow-up period of 528 days (1.5 years). Average VAS for combined back and leg pain significantly improved from a preoperative value of 9.0 to a postoperative value of 1.1 (P ≤ 0.0001), a change of 7.9 points for the cohort. The average number of lumbar disc levels fused per patient was 2.3 (range 1-4). Median postoperative LOS in the hospital was 1.2 days. Average blood loss was 108 ml perfused level. Complications occurred in 5% of patients (n = 11) and the rate of reoperation for symptomatic adjacent segment disease was 2% (n = 4). Complications included reoperation at index level for symptomatic pseudoarthrosis with hardware failure (n = 3); surgical site infection (n = 7); repair of cerebrospinal fluid leak (n = 1), and one patient death at home 3 days after discharge. Conclusion: Lumbar fusion for symptomatic DDD can be a safe and effective treatment for medically refractory LBP with or without leg pain. PMID:26692696

  10. Transforaminal endoscopic surgery for lumbar stenosis: a systematic review

    PubMed Central

    Nellensteijn, Jorm; Bartels, Ronald; Peul, Wilco; van Royen, Barend; van Tulder, Maurits

    2010-01-01

    Transforaminal endoscopic techniques have become increasingly popular in surgery of patients with lumbar stenosis. The literature has not yet been systematically reviewed. A comprehensive systematic literature review up to November 2009 to assess the effectiveness of transforaminal endoscopic surgery in patients with symptomatic lumbar stenosis was made. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality, and relevant data, including outcomes, were extracted by two reviewers independently. No randomized controlled trials were identified, but seven observational studies. The studies were of poor methodological quality and heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures. Overall, 69–83% reported the outcome as satisfactory and a complication rate of 0–8.3%. The reported re-operation rate varied from 0 to 20%. At present, there is no valid evidence from randomized controlled trials on the effectiveness of transforaminal endoscopic surgery for lumbar stenosis. Randomized controlled trials comparing transforaminal endoscopic surgery with other surgical techniques are direly needed. PMID:20087610

  11. The SNAP trial: a double blind multi-center randomized controlled trial of a silicon nitride versus a PEEK cage in transforaminal lumbar interbody fusion in patients with symptomatic degenerative lumbar disc disorders: study protocol

    PubMed Central

    2014-01-01

    Background Polyetheretherketone (PEEK) cages have been widely used in the treatment of lumbar degenerative disc disorders, and show good clinical results. Still, complications such as subsidence and migration of the cage are frequently seen. A lack of osteointegration and fibrous tissues surrounding PEEK cages are held responsible. Ceramic implants made of silicon nitride show better biocompatible and osteoconductive qualities, and therefore are expected to lower complication rates and allow for better fusion. Purpose of this study is to show that fusion with the silicon nitride cage produces non-inferior results in outcome of the Roland Morris Disability Questionnaire at all follow-up time points as compared to the same procedure with PEEK cages. Methods/Design This study is designed as a double blind multi-center randomized controlled trial with repeated measures analysis. 100 patients (18–75 years) presenting with symptomatic lumbar degenerative disorders unresponsive to at least 6 months of conservative treatment are included. Patients will be randomly assigned to a PEEK cage or a silicon nitride cage, and will undergo a transforaminal lumbar interbody fusion with pedicle screw fixation. Primary outcome measure is the functional improvement measured by the Roland Morris Disability Questionnaire. Secondary outcome parameters are the VAS leg, VAS back, SF-36, Likert scale, neurological outcome and radiographic assessment of fusion. After 1 year the fusion rate will be measured by radiograms and CT. Follow-up will be continued for 2 years. Patients and clinical observers who will perform the follow-up visits will be blinded for type of cage used during follow-up. Analyses of radiograms and CT will be performed independently by two experienced radiologists. Discussion In this study a PEEK cage will be compared with a silicon nitride cage in the treatment of symptomatic degenerative lumbar disc disorders. To our knowledge, this is the first randomized controlled

  12. The “inside out” transforaminal technique to treat lumbar spinal pain in an awake and aware patient under local anesthesia: results and a review of the literature

    PubMed Central

    Gore, Satishchandra

    2014-01-01

    Surgical management of back and leg pain is evolving and changing due to a better understanding of the patho-anatomy well correlated with its pathophysiology. Pain is better understood with in vivo visualization and probing of the pain generators using an endoscopic access rather than just relying on symptoms diagram and image correlation. This has resulted in a shared decision making involving patient and surgeon, focused on a broader spectrum of surgical as well as non-surgical treatments, and not just masking the pain generator. It has moved away from decisions based on diagnostic images alone, that, while noting the image alterations, cannot explain the pain experienced by each individual as images do not always show variations in nerve supply and patho-anatomy. The ability to isolate and visualize “pain” generators in the foramen and treating persistent pain by visualizing inflammation and compression of nerves, serves as the basis for transforaminal endoscopic (TFE) surgery. This has also resulted in better pre surgical planning with more specific and defined goals in mind. The “Inside out” philosophy of TFE surgery is safe and precise. It provides basic access to the disc and foramen to cover a large spectrum of painful pathologies. PMID:25694940

  13. A Review of Data Fusion Techniques

    PubMed Central

    2013-01-01

    The integration of data and knowledge from several sources is known as data fusion. This paper summarizes the state of the data fusion field and describes the most relevant studies. We first enumerate and explain different classification schemes for data fusion. Then, the most common algorithms are reviewed. These methods and algorithms are presented using three different categories: (i) data association, (ii) state estimation, and (iii) decision fusion. PMID:24288502

  14. Incidence of intravascular penetration in transforaminal cervical epidural steroid injections.

    PubMed

    Furman, Michael B; Giovanniello, Michael T; O'Brien, Erin M

    2003-01-01

    STUDY DESIGN A prospective, observational, human, study was conducted. OBJECTIVES To evaluate the incidence of vascular penetration during fluoroscopically guided, contrast-enhanced transforaminal cervical epidural steroid injections, and to determine whether the observation of blood in the needle hub can be used to predict a vascular injection. SUMMARY OF BACKGROUND DATA Incorrectly placed intravascular cervical spinal injections result in medication flow systemically and not to the desired target. A recently published study demonstrates a high incidence of intravascular injections in transforaminal lumbosacral epidural injections. No studies so far have evaluated the incidence of vascular injections in transforaminal cervical epidural steroid injections, nor have they calculated the ability of observed blood in the needle hub to predict a vascular injection in the cervical spine.METHODS The incidence of fluoroscopically confirmed intravascular uptake of contrast was prospectively observed in 337 patients treated with cervical transforaminal epidural steroid injections. The ability of observed blood in the needle hub to predict intravascular injection was also investigated. For each subject, the injection level was chosen on the basis of the clinical scenario including history, physical examination, and review of imaging studies. Some patients had multilevel injections. Using fluoroscopic guidance, the authors placed a 25-gauge needle into the epidural space using a transforaminal approach according to accepted standard technique. Needle tip location was confirmed with biplanar imaging. The presence or absence of blood in the needle hub spontaneously ("flash") and after attempted aspiration by pulling back on the syringe's plunger was documented. Contrast then was injected under real-time fluoroscopy to determine whether the location of the needle tip was intravascular. The results were recorded in a prospective manner indicating the presence or absence of blood

  15. Transforaminal full-endoscopic lumbar discectomy in obese patients

    PubMed Central

    Bae, Jun Seok

    2016-01-01

    Background Obese patients are at risk of complications such as slower wound healing and increased infection rates after spinal surgery. Transforaminal full-endoscopic lumbar discectomy (ELD) has advantages over conventional microdiscectomy because it decreases perioperative complications and increases favorable clinical outcomes. No clinical studies have reported ELD in obese patients. The purpose of this study is to evaluate the clinical outcomes of transforaminal ELD in obese patients Methods Obesity is defined as a body mass index (BMI) of more than 30 kg/m2. Our study included 21 obese patients and 27 normal BMI patients treated by posterolateral transforaminal ELD for radiating pain caused by a single-level lumbar disc herniation with more than 2 years of follow-up. Clinical chart reviews and telephone surveys were conducted. Clinical and functional outcomes using VAS and ODI, perioperative complications, and reherniation were evaluated. Results Overall clinical and functional outcomes were improved during postoperative follow-up evaluation. There were no immediate perioperative complications, such as infection or durotomy in both groups. In obese group, three patients had late reherniations. Of these, 2 patients had tolerable pain and showed good recovery with conservative treatment; 1 patient who had undergone ELD for recurrent disc herniation underwent open microdiscectomy. In control group, two patients had early reherniation and underwent open microdiscectomy and one patient with late reherniation showed good recovery with conservative treatment. Conclusion In select cases, ELD is an effective, safe, and minimally invasive technique for obese patients. It decreases perioperative morbidity and allows for both early mobilization and early return to work. Level of Evidence: level 3b. PMID:27441176

  16. Lateral Lumbar Interbody Fusion

    PubMed Central

    Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-01-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  17. Lateral Lumbar Interbody Fusion.

    PubMed

    Pawar, Abhijit; Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-12-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  18. Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature

    PubMed Central

    Nellensteijn, Jorm; Bartels, Ronald; Peul, Wilco; van Royen, Barend; van Tulder, Maurits

    2009-01-01

    The study design includes a systematic literature review. The objective of the study was to evaluate the effectiveness of transforaminal endoscopic surgery and to compare this with open microdiscectomy in patients with symptomatic lumbar disc herniations. Transforaminal endoscopic techniques for patients with symptomatic lumbar disc herniations have become increasingly popular. The literature has not yet been systematically reviewed. A comprehensive systematic literature search of the MEDLINE and EMBASE databases was performed up to May 2008. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality and outcomes were extracted by the two reviewers independently. One randomized controlled trial, 7 non-randomized controlled trials and 31 observational studies were identified. Studies were heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures and the methodological quality of these studies was poor. The eight trials did not find any statistically significant differences in leg pain reduction between the transforaminal endoscopic surgery group (89%) and the open microdiscectomy group (87%); overall improvement (84 vs. 78%), re-operation rate (6.8 vs. 4.7%) and complication rate (1.5 vs. 1%), respectively. In conclusion, current evidence on the effectiveness of transforaminal endoscopic surgery is poor and does not provide valid information to either support or refute using this type of surgery in patients with symptomatic lumbar disc herniations. High-quality randomized controlled trials with sufficiently large sample sizes are direly needed to evaluate if transforaminal endoscopic surgery is more effective than open microdiscectomy. PMID:19756781

  19. Application of image fusion techniques in DSA

    NASA Astrophysics Data System (ADS)

    Ye, Feng; Wu, Jian; Cui, Zhiming; Xu, Jing

    2007-12-01

    Digital subtraction angiography (DSA) is an important technology in both medical diagnoses and interposal therapy, which can eliminate the interferential background and give prominence to blood vessels by computer processing. After contrast material is injected into an artery or vein, a physician produces fluoroscopic images. Using these digitized images, a computer subtracts the image made with contrast material from a series of post injection images made without background information. By analyzing the characteristics of DSA medical images, this paper provides a solution of image fusion which is in allusion to the application of DSA subtraction. We fuse the images of angiogram and subtraction, in order to obtain the new image which has more data information. The image that fused by wavelet transform can display the blood vessels and background information clearly, and medical experts gave high score on the effect of it.

  20. A novel technique using hydrophilic polymers to promote axonal fusion

    PubMed Central

    Bamba, Ravinder; Riley, D. Colton; Kelm, Nathaniel D.; Does, Mark D.; Dortch, Richard D.; Thayer, Wesley P.

    2016-01-01

    The management of traumatic peripheral nerve injury remains a considerable concern for clinicians. With minimal innovations in surgical technique and a limited number of specialists trained to treat peripheral nerve injury, outcomes of surgical intervention have been unpredictable. The inability to manipulate the pathophysiology of nerve injury (i.e., Wallerian degeneration) has left scientists and clinicians depending on the slow and lengthy process of axonal regeneration (~1 mm/day). When axons are severed, the endings undergo calcium-mediated plasmalemmal sealing, which limits the ability of the axon to be primarily repaired. Polythethylene glycol (PEG) in combination with a bioengineered process overcomes the inability to fuse axons. The mechanism for PEG axonal fusion is not clearly understood, but multiple studies have shown that a providing a calcium-free environment is essential to the process known as PEG fusion. The proposed mechanism is PEG-induced lipid bilayer fusion by removing the hydration barrier surrounding the axolemma and reducing the activation energy required for membrane fusion to occur. This review highlights PEG fusion, its past and current studies, and future directions in PEG fusion. PMID:27212898

  1. A novel technique using hydrophilic polymers to promote axonal fusion.

    PubMed

    Bamba, Ravinder; Riley, D Colton; Kelm, Nathaniel D; Does, Mark D; Dortch, Richard D; Thayer, Wesley P

    2016-04-01

    The management of traumatic peripheral nerve injury remains a considerable concern for clinicians. With minimal innovations in surgical technique and a limited number of specialists trained to treat peripheral nerve injury, outcomes of surgical intervention have been unpredictable. The inability to manipulate the pathophysiology of nerve injury (i.e., Wallerian degeneration) has left scientists and clinicians depending on the slow and lengthy process of axonal regeneration (~1 mm/day). When axons are severed, the endings undergo calcium-mediated plasmalemmal sealing, which limits the ability of the axon to be primarily repaired. Polythethylene glycol (PEG) in combination with a bioengineered process overcomes the inability to fuse axons. The mechanism for PEG axonal fusion is not clearly understood, but multiple studies have shown that a providing a calcium-free environment is essential to the process known as PEG fusion. The proposed mechanism is PEG-induced lipid bilayer fusion by removing the hydration barrier surrounding the axolemma and reducing the activation energy required for membrane fusion to occur. This review highlights PEG fusion, its past and current studies, and future directions in PEG fusion. PMID:27212898

  2. Review of early clinical results and complications associated with oblique lumbar interbody fusion (OLIF).

    PubMed

    Phan, Kevin; Maharaj, Monish; Assem, Yusuf; Mobbs, Ralph J

    2016-09-01

    Lumbar interbody fusion represents an effective surgical intervention for patients with lumbar degenerative diseases, spondylolisthesis, disc herniation, pseudoarthrosis and spinal deformities. Traditionally, conventional open anterior lumbar interbody fusion and posterior/transforaminal lumbar interbody fusion techniques have been employed with excellent results, but each with their own advantages and caveats. Most recently, the antero-oblique trajectory has been introduced, providing yet another corridor to access the lumbar spine. Termed the oblique lumbar interbody fusion, this approach accesses the spine between the anterior vessels and psoas muscles, avoiding both sets of structures to allow efficient clearance of the disc space and application of a large interbody device to afford distraction for foraminal decompression and endplate preparation for rapid and thorough fusion. This review aims to summarize the early clinical results and complications of this new technique and discusses potential future directions of research. PMID:27349468

  3. Vegetation change detection based on image fusion technique

    NASA Astrophysics Data System (ADS)

    Jia, Yonghong; Liu, Yueyan; Yu, Hui; Li, Deren

    2005-10-01

    The change detection of land use and land cover has always been the focus of remotely sensed study and application. Based on techniques of image fusion, a new approach of detecting vegetation change according to vector of brightness index (BI) and perpendicular vegetation index (PVI) extracted from multi-temporal remotely sensed imagery is proposed. The procedure is introduced. Firstly, the Landsat eTM+ imagery is geometrically corrected and registered. Secondly, band 2,3,4 and panchromatic images of Landsat eTM+ are fused by a trous wavelet fusion, and bands 1,2,3 of SPOT are registered to the fused images. Thirdly, brightness index and perpendicular vegetation index are respectively extracted from SPOT images and fused images. Finally, change vectors are obtained and used to detect vegetation change. The testing results show that the approach of detecting vegetation change is very efficient.

  4. Patient radiation exposure during transforaminal lumbar endoscopic spine surgery: a prospective study.

    PubMed

    Iprenburg, Menno; Wagner, Ralf; Godschalx, Alexander; Telfeian, Albert E

    2016-02-01

    OBJECTIVE The aim of this study was to describe patient radiation exposure during single-level transforaminal endoscopic lumbar discectomy procedures at levels L2-5 and L5-S1. METHODS Radiation exposure was monitored in 151 consecutive patients undergoing single-level transforaminal endoscopic lumbar discectomy procedures. Two groups were studied: patients undergoing procedures at the L4-5 level or above and those undergoing an L5-S1 procedure. RESULTS For the discectomy procedures at L4-5 and above, the average duration of fluoroscopy was 38.4 seconds and the mean calculated patient radiation exposure dose was 1.5 mSv. For the L5-S1 procedures, average fluoroscopy time was 54.6 seconds and the mean calculated radiation exposure dose was 2.1 mSv. The average patient radiation exposure dose among these cases represents a 3.5-fold decrease compared with the senior surgeon's first 100 cases. CONCLUSIONS Transforaminal lumbar endoscopic discectomy can be used as a minimally invasive technique for the treatment of lumbar radiculopathy in the setting of a herniated lumbar disc without the significant concern of exposing the patient to harmful doses of radiation. One caveat is that both the surgeon and the patient are likely to be exposed to higher doses of radiation during a surgeon's early experience in minimally invasive endoscopic spine surgery. PMID:26828888

  5. A blunt needle (Epimed®) does not eliminate the risk of vascular penetration during transforaminal epidural injection

    PubMed Central

    Ilkhchoui, Yashar; Koshkin, Eugene

    2013-01-01

    Background: Transforaminal epidural injection of local anesthetics and corticosteroids is a common practice in patients with radicular pain. However, serious morbidity has also been reported, which can be attributed to an arterial or venous injection of the medication especially particulate glucocorticoid preparations. Using a blunt needle in contrast to sharp needle has been suggested to reduce this risk in a study on animals. Case Description: We present a 59-year-old female with L5 lumbar radicular symptoms and left L5-S1 foraminal narrowing who underwent transforaminal epidural injection with fluoroscopic guidance using a 22-gauge blunt curved needle (Epimed®, Johnstown, NY). Intravascular needle placement was detected during real-time contrast injection under live fluoroscopy after a negative aspiration and local anesthetic test dose. The needle was slightly withdrawn and correct distribution of the contrast was confirmed along the target nerve root and into the epidural space. Conclusion: This case report discusses vascular penetration utilizing an Epimed® blunt needle to perform transforaminal injections in a clinical setting. This topic was previously discussed in earlier animal studies. We also reemphasize that neither negative aspiration or local anesthetic test doses are reliable techniques to ensure the safety of transforaminal epidural injections. PMID:24340239

  6. The SIGN nail for knee fusion: technique and clinical results

    PubMed Central

    Anderson, Duane Ray; Anderson, Lucas Aaron; Haller, Justin M.; Feyissa, Abebe Chala

    2016-01-01

    Purpose: Evaluate the efficacy of using the SIGN nail for instrumented knee fusion. Methods: Six consecutive patients (seven knees, three males) with an average age of 30.5 years (range, 18–50 years) underwent a knee arthrodesis with SIGN nail (mean follow-up 10.7 months; range, 8–14 months). Diagnoses included tuberculosis (two knees), congenital knee dislocation in two knees (one patient), bacterial septic arthritis (one knee), malunited spontaneous fusion (one knee), and severe gout with 90° flexion contracture (one knee). The nail was inserted through an anteromedial entry point on the femur and full weightbearing was permitted immediately. Results: All knees had clinical and radiographic evidence of fusion at final follow-up and none required further surgery. Four of six patients ambulated without assistive device, and all patients reported improved overall physical function. There were no post-operative complications. Conclusion: The technique described utilizing the SIGN nail is both safe and effective for knee arthrodesis and useful for austere environments with limited fluoroscopy and implant options. PMID:27163095

  7. Intervertebral Fusion with Mobile Microendoscopic Discectomy for Lumbar Degenerative Disc Disease.

    PubMed

    Xu, Bao-Shan; Liu, Yue; Xu, Hai-Wei; Yang, Qiang; Ma, Xin-Long; Hu, Yong-Cheng

    2016-05-01

    The aim of this article is to introduce a technique for lumbar intervertebral fusion that incorporates mobile microendoscopic discectomy (MMED) for lumbar degenerative disc disease. Minimally invasive transforaminal lumbar interbody fusion is frequently performed to treat degenerative diseases of the lumbar spine; however, the scope of such surgery and vision is limited by what the naked eye can see through the expanding channel system. To expand the visual scope and reduce trauma, we perform lumbar intervertebral fusion with the aid of a MMED system that provides a wide field through freely tilting the surgical instrument and canals. We believe that this technique is a good option for treating lumbar degenerative disc disease that requires lumbar intervertebral fusion. PMID:27384734

  8. Colour Image Segmentation Using Homogeneity Method and Data Fusion Techniques

    NASA Astrophysics Data System (ADS)

    Ben Chaabane, Salim; Sayadi, Mounir; Fnaiech, Farhat; Brassart, Eric

    2009-12-01

    A novel method of colour image segmentation based on fuzzy homogeneity and data fusion techniques is presented. The general idea of mass function estimation in the Dempster-Shafer evidence theory of the histogram is extended to the homogeneity domain. The fuzzy homogeneity vector is used to determine the fuzzy region in each primitive colour, whereas, the evidence theory is employed to merge different data sources in order to increase the quality of the information and to obtain an optimal segmented image. Segmentation results from the proposed method are validated and the classification accuracy for the test data available is evaluated, and then a comparative study versus existing techniques is presented. The experimental results demonstrate the superiority of introducing the fuzzy homogeneity method in evidence theory for image segmentation.

  9. Effervescence Assisted Fusion Technique to Enhance the Solubility of Drugs.

    PubMed

    Alam, Mohd Aftab; Al-Jenoobi, Fahad I; Al-Mohizea, Abdullah M; Ali, Raisuddin

    2015-12-01

    The solubility of five poorly soluble drugs was enhanced by using an effervescence assisted solid dispersion (EASD) technique. EASDs were prepared by using modified fusion method. Drug and hydrophilic carrier were melted, and in this molten mixture, effervescence was generated by adding effervescence couple comprising organic acid (citric acid) and carbonic base (sodium bicarbonate). Solubility of drug powders, solid dispersions, and EASDs was determined at 25°C using shake flask method. Atorvastatin calcium, cefuroxime axetil, clotrimazole, ketoconazole, and metronidazole benzoate were estimated using a spectrophotometer at 246, 280, 260, 230, and 232 nm (λ max), respectively. Solubility of atorvastatin calcium (from 100 to 345 μg/ml), cefuroxime axetil (from 441 to 1948 μg/ml), clotrimazole (from 63 to 677 μg/ml), ketoconazole (from 16 to 500 μg/ml), and metronidazole benzoate (from 112 to 208 μg/ml) in EASDs was enhanced by 3.45-, 4.4-, 10.7-, 31.2-, and 1.8-fold, respectively. Scanning electron micrographs of drug powder, solid dispersion, and EASDs were compared. Scanning electron micrographs of EASDs showed a uniform distribution of drug particles in the carrier matrix. Morphology (size and shape) of cefuroxime axetil particles was altered in solid dispersion as well as in EASD. EASDs showed better solubility enhancement than conventional solid dispersions. The present technique is better suitable for drugs having a low melting point or melt without charring. Effervescence assisted fusion technique of preparing solid dispersions can be employed for enhancing solubility, dissolution, and bioavailability of poorly soluble drugs. PMID:26265190

  10. Efficacy of Epidural Steroid Injection in Management of Lumbar Prolapsed Intervertebral Disc: A Comparison of Caudal, Transforaminal and Interlaminar Routes

    PubMed Central

    2016-01-01

    Introduction Epidural steroid is an important modality in the conservative management of prolapsed lumbar disc and is being used for over 50 years. However, controversy still persists regarding their effectiveness in reducing the pain and improving the function with literature both supporting and opposing them are available. Aim To study the efficacy of epidural steroid injection in the management of pain due to prolapsed lumbar intervertebral disc and to compare the effectiveness between caudal, transforaminal and interlaminar routes of injection. Materials and Methods A total of 152 patients with back pain with or without radiculopathy with a lumbar disc prolapse confirmed on MRI, were included in the study and their pre injection Japanese Orthopaedic Association (JOA) Score was calculated. By simple randomization method (picking a card), patients were enrolled into one of the three groups and then injected methyl prednisone in the epidural space by one of the techniques of injection i.e. caudal, transforaminal and interlaminar. Twelve patients didn’t turn up for the treatment and hence were excluded from the study. Remaining 140 patients were treated and were included for the analysis of the results. Eighty two patients received injection by caudal route, 40 by transforaminal route and 18 by interlaminar route. Post injection JOA Score was calculated at six month and one year and effectiveness of the medication was calculated for each route. The data was compared by LSD and ANOVA method to prove the significance. Average follow-up was one year. Results At one year after injecting the steroid, all three routes were found to be effective in improving the JOA Score (Caudal route in 74.3%, transforaminal in 90% and interlaminar in 77.7%). Transforaminal route was significantly more effective than caudal (p=0.00) and interlaminar route (p=0.03) at both 6 months and one year after injection. No significant difference was seen between the caudal and interlaminar

  11. Occipitocervical Fusion Surgery: Review of Operative Techniques and Results.

    PubMed

    Kukreja, Sunil; Ambekar, Sudheer; Sin, Anthony H; Nanda, Anil

    2015-09-01

    Objective Varying types of clinicoradiologic presentations at the craniovertebral junction (CVJ) influence the decision process for occipitocervical fusion (OCF) surgery. We discuss the operative techniques and decision-making process in OCF surgery based on our clinical experience and a literature review. Material and Methods A total of 49 consecutive patients who underwent OCF participated in the study. Sagittal computed tomography images were used to illustrate and measure radiologic parameters. We measured Wackenheim clivus baseline (WCB), clivus-canal angle (CCA), atlantodental distance (ADD), and Powers ratio (PR) in all the patients. Results Clinical improvement on Nurick grading was recorded in 36 patients. Patients with better preoperative status (Nurick grades 1-3) had better functional outcomes after the surgery (p = 0.077). Restoration of WCB, CCA, ADD, and PR parameters following the surgery was noted in 39.2%, 34.6%, 77.4%, and 63.3% of the patients, respectively. Complications included deep wound infections (n = 2), pseudoarthrosis (n = 2), and deaths (n = 4). Conclusion Conventional wire-based constructs are superseded by more rigid screw-based designs. Odontoidectomy is associated with a high incidence of perioperative complications. The advent of newer implants and reduction techniques around the CVJ has obviated the need for this procedure in most patients. PMID:26401473

  12. Is transforaminal retrieval of intradiscal deeply seated broken surgical knife blade all time pars sparing? A case report

    PubMed Central

    Rahimizadeh, Abolfazl; Haddadi, Kaveh

    2015-01-01

    Background One risk accompanying with Lumbar discectomy is breaking of the surgical scalpel during discectomy. Greatest of the broken blades can be detached during the first surgery. Conversely, in few cases, surgeon’s efforts might be ineffective, causing in engaged foreign body in the disc space. Works regarding this matter is infrequent, and there are no exclusive strategies to discourse this complication. Presentation of case A 26-year-old female with L5-S1 left disc sequestration and plantar flexion disturbance, underwent a one level hemilaminectomy for lumbar disc herniation. The knife blade was broken in the disc space and could not be found despite 3 h consumed on its tried removal by her surgeon. Transforaminal path as an unconventional access strip for its removal is planned, but pars inter articularis was not saving intact and fusion process had done.The patient was discharged a day after blade removal and fusion surgery is doing well now. Conclusions The transforaminal route might be a harmless and informal substitute corridor for all intradiscal retained foreign bodies including a broken blade. Sometimes because of better exposure especially in deeply seated material, resection of pars and then fusion surgery avoid inevitable. PMID:26748209

  13. Midfoot fusion technique for neuroarthropathic feet: biomechanical analysis and rationale.

    PubMed

    Marks, R M; Parks, B G; Schon, L C

    1998-08-01

    To test the hypothesis that a plate applied to the plantar (tension) side of the medial midfoot provides stronger fixation than midfoot fusion with screw fixation, we biomechanically compared the two constructs for midfoot fusion. We created a model of midfoot instability in eight matched pairs of cadaver legs by section of joint capsule, ligaments, and tendons about Lisfranc's joints, and then performed a load-to-failure study to compare the fixation provided by a plantarly applied third tubular plate with that by cortical screws. After an initial load deformation curve to 1000 N was obtained, specimens were cyclically loaded at 200 to 750 N for 3000 cycles and then loaded to failure (screw pullout, fracture, or deformation >3 mm). Comparing the plantar plate and midfoot fusion with screw fixation constructs, a plate applied to the plantar (tension) aspect of the medial midfoot provides a stronger, sturdier construct than does midfoot fusion with screw fixation. PMID:9728696

  14. Multimodality Image Fusion-Guided Procedures: Technique, Accuracy, and Applications

    SciTech Connect

    Abi-Jaoudeh, Nadine; Kruecker, Jochen; Kadoury, Samuel; Kobeiter, Hicham; Venkatesan, Aradhana M. Levy, Elliot Wood, Bradford J.

    2012-10-15

    Personalized therapies play an increasingly critical role in cancer care: Image guidance with multimodality image fusion facilitates the targeting of specific tissue for tissue characterization and plays a role in drug discovery and optimization of tailored therapies. Positron-emission tomography (PET), magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CT) may offer additional information not otherwise available to the operator during minimally invasive image-guided procedures, such as biopsy and ablation. With use of multimodality image fusion for image-guided interventions, navigation with advanced modalities does not require the physical presence of the PET, MRI, or CT imaging system. Several commercially available methods of image-fusion and device navigation are reviewed along with an explanation of common tracking hardware and software. An overview of current clinical applications for multimodality navigation is provided.

  15. Multimodality Image Fusion Guided Procedures: Technique, Accuracy, and Applications

    PubMed Central

    Abi-Jaoudeh, Nadine; Kruecker, Jochen; Kadoury, Samuel; Kobeiter, Hicham; Venkatesan, Aradhana M.; Levy, Elliot; Wood, Bradford J.

    2012-01-01

    Personalized therapies play an increasingly critical role in cancer care; Image guidance with multimodality image fusion facilitates the targeting of specific tissue for tissue characterization, and plays a role in drug discovery and optimization of tailored therapies. PET, MRI and contrast enhanced CT may offer additional information not otherwise available to the operator during minimally invasive image guided procedures such as biopsy and ablation. With use of multimodality image fusion for image-guided interventions, navigation with advanced modalities does not require the physical presence of the PET, MRI, or CT imaging system. Several commercially available methods of image fusion and device navigation are reviewed along with an explanation of common tracking hardware and software. An overview of current clinical applications for multimodality navigation is provided. PMID:22851166

  16. Technical considerations in transforaminal endoscopic spine surgery at the thoracolumbar junction: report of 3 cases.

    PubMed

    Telfeian, Albert E; Jasper, Gabriele P; Oyelese, Adetokunbo A; Gokaslan, Ziya L

    2016-02-01

    OBJECTIVE In this study the authors describe the technical considerations and feasibility of transforaminal discectomy and foraminoplasty for the treatment of lumbar radiculopathy in patients who have herniated discs at the thoracolumbar junction. METHODS After institutional review board approval, charts from 3 consecutive patients with lumbar radiculopathy and T12-L1 herniated discs who underwent endoscopic procedures between 2006 and 2014 were reviewed. RESULTS Consecutive cases (n = 1316) were reviewed to determine the incidence and success of surgery performed at the T12-L1 level. Only 3 patients (0.23%) treated with endoscopic surgery for their herniated discs had T12-L1 herniated discs; the rest were lumbar or lumbosacral herniations. For patients with T12-L1 disc herniations, the average preoperative visual analog scale score was 8.3 (indicated in the questionnaire as describing severe and constant pain). The average 1-year postoperative visual analog scale score was 1.7 (indicated in the questionnaire as mild and intermittent pain). CONCLUSIONS Transforaminal endoscopic discectomy and foraminotomy can be used as a safe yet minimally invasive technique for the treatment of lumbar radiculopathy in the setting of a thoracolumbar disc herniation. PMID:26828890

  17. Multi-intelligence critical rating assessment of fusion techniques (MiCRAFT)

    NASA Astrophysics Data System (ADS)

    Blasch, Erik

    2015-06-01

    Assessment of multi-intelligence fusion techniques includes credibility of algorithm performance, quality of results against mission needs, and usability in a work-domain context. Situation awareness (SAW) brings together low-level information fusion (tracking and identification), high-level information fusion (threat and scenario-based assessment), and information fusion level 5 user refinement (physical, cognitive, and information tasks). To measure SAW, we discuss the SAGAT (Situational Awareness Global Assessment Technique) technique for a multi-intelligence fusion (MIF) system assessment that focuses on the advantages of MIF against single intelligence sources. Building on the NASA TLX (Task Load Index), SAGAT probes, SART (Situational Awareness Rating Technique) questionnaires, and CDM (Critical Decision Method) decision points; we highlight these tools for use in a Multi-Intelligence Critical Rating Assessment of Fusion Techniques (MiCRAFT). The focus is to measure user refinement of a situation over the information fusion quality of service (QoS) metrics: timeliness, accuracy, confidence, workload (cost), and attention (throughput). A key component of any user analysis includes correlation, association, and summarization of data; so we also seek measures of product quality and QuEST of information. Building a notion of product quality from multi-intelligence tools is typically subjective which needs to be aligned with objective machine metrics.

  18. Evaluating fusion techniques for multi-sensor satellite image data

    SciTech Connect

    Martin, Benjamin W; Vatsavai, Raju

    2013-01-01

    Satellite image data fusion is a topic of interest in many areas including environmental monitoring, emergency response, and defense. Typically any single satellite sensor cannot provide all of the benefits offered by a combination of different sensors (e.g., high-spatial but low spectral resolution vs. low-spatial but high spectral, optical vs. SAR). Given the respective strengths and weaknesses of the different types of image data, it is beneficial to fuse many types of image data to extract as much information as possible from the data. Our work focuses on the fusion of multi-sensor image data into a unified representation that incorporates the potential strengths of a sensor in order to minimize classification error. Of particular interest is the fusion of optical and synthetic aperture radar (SAR) images into a single, multispectral image of the best possible spatial resolution. We explore various methods to optimally fuse these images and evaluate the quality of the image fusion by using K-means clustering to categorize regions in the fused images and comparing the accuracies of the resulting categorization maps.

  19. Segmentation Fusion Techniques with Application to Plenoptic Images: A Survey.

    NASA Astrophysics Data System (ADS)

    Evin, D.; Hadad, A.; Solano, A.; Drozdowicz, B.

    2016-04-01

    The segmentation of anatomical and pathological structures plays a key role in the characterization of clinically relevant evidence from digital images. Recently, plenoptic imaging has emerged as a new promise to enrich the diagnostic potential of conventional photography. Since the plenoptic images comprises a set of slightly different versions of the target scene, we propose to make use of those images to improve the segmentation quality in relation to the scenario of a single image segmentation. The problem of finding a segmentation solution from multiple images of a single scene, is called segmentation fusion. This paper reviews the issue of segmentation fusion in order to find solutions that can be applied to plenoptic images, particularly images from the ophthalmological domain.

  20. Fusion Techniques for the Oxidation of Refractory Actinide Oxides

    SciTech Connect

    Rudisill, T.S.

    1999-04-15

    Small-scale experiments were performed to demonstrate the feasibility of fusing refractory actinide oxides with a series of materials commonly used to decompose minerals, glasses, and other refractories as a pretreatment to dissolution and subsequent recovery operations. In these experiments, 1-2 g of plutonium or neptunium oxide (PuO2 or NpO2) were calcined at 900 degrees Celsius, mixed and heated with the fusing reagent(s), and dissolved. For refractory PuO2, the most effective material tested was a lithium carbonate (Li2CO3)/sodium tetraborate (Na2B4O7) mixture which aided in the recovery of 90 percent of the plutonium. The fused product was identified as a lithium plutonate (Li3PuO4) by x-ray diffraction. The use of a Li2CO3/Na2B4O7 mixture to solubilize high-fired NpO2 was not as effective as demonstrated for refractory PuO2. In a small-scale experiment, 25 percent of the NpO2 was oxidized to a neptunium (VI) species that dissolved in nitric acid. The remaining neptunium was then easily recovered from the residue by fusing with sodium peroxide (Na2O2). Approximately 70 percent of the neptunium dissolved in water to yield a basic solution of neptunium (VII). The remainder was recovered as a neptunium (VI) solution by dissolving the residue in 8M nitric acid. In subsequent experiments with Na2O2, the ratio of neptunium (VII) to (VI) was shown to be a function of the fusion temperature, with higher temperatures (greater than approximately 400 degrees C) favoring the formation of neptunium (VII). The fusion of an actual plutonium-containing residue with Na2O2 and subsequent dissolution was performed to demonstrate the feasibility of a pretreatment process on a larger scale. Sodium peroxide was chosen due

  1. Anterior Lumbar Interbody Fusion as a Salvage Technique for Pseudarthrosis following Posterior Lumbar Fusion Surgery

    PubMed Central

    Mobbs, Ralph J.; Phan, Kevin; Thayaparan, Ganesha K.; Rao, Prashanth J.

    2015-01-01

    Study Design Retrospective analysis of prospectively collected observational data. Objective To assess the safety and efficacy of anterior lumbar interbody fusion (ALIF) as a salvage option for lumbar pseudarthrosis following failed posterior lumbar fusion surgery. Methods From 2009 to 2013, patient outcome data was collected prospectively over 5 years from 327 patients undergoing ALIF performed by a single surgeon (R.J.M.) with 478 levels performed. Among these, there were 20 cases of failed prior posterior fusion that subsequently underwent ALIF. Visual analog score (VAS), Oswestry Disability Index (ODI), and Short Form 12-item health survey (SF-12) were measured pre- and postoperatively. The verification of fusion was determined by utilizing a fine-cut computed tomography scan at 12-month follow-up. Results There was a significant difference between the preoperative (7.25 ± 0.8) and postoperative (3.1 ± 2.1) VAS scores (p < 0.0001). The ODI scale also demonstrated a statistically significant reduction from preoperative (56.3 ± 16.5) and postoperative (30.4 ± 19.3) scores (p < 0.0001). The SF-12 scores were significantly improved after ALIF salvage surgery: Physical Health Composite Score (32.18 ± 5.5 versus 41.07 ± 9.67, p = 0.0003) and Mental Health Composite Score (36.62 ± 12.25 versus 50.89 ± 10.86, p = 0.0001). Overall, 19 patients (95%) achieved successful fusion. Conclusions Overall, our results suggest that the ALIF procedure results not only in radiographic improvements in bony fusion but in significant improvements in the patient's physical and mental experience of pain secondary to lumbar pseudarthrosis. Future multicenter registry studies and randomized controlled trials should be conducted to confirm the long-term benefit of ALIF as a salvage option for failed posterior lumbar fusion. PMID:26835197

  2. Anterior Lumbar Interbody Fusion as a Salvage Technique for Pseudarthrosis following Posterior Lumbar Fusion Surgery.

    PubMed

    Mobbs, Ralph J; Phan, Kevin; Thayaparan, Ganesha K; Rao, Prashanth J

    2016-02-01

    Study Design Retrospective analysis of prospectively collected observational data. Objective To assess the safety and efficacy of anterior lumbar interbody fusion (ALIF) as a salvage option for lumbar pseudarthrosis following failed posterior lumbar fusion surgery. Methods From 2009 to 2013, patient outcome data was collected prospectively over 5 years from 327 patients undergoing ALIF performed by a single surgeon (R.J.M.) with 478 levels performed. Among these, there were 20 cases of failed prior posterior fusion that subsequently underwent ALIF. Visual analog score (VAS), Oswestry Disability Index (ODI), and Short Form 12-item health survey (SF-12) were measured pre- and postoperatively. The verification of fusion was determined by utilizing a fine-cut computed tomography scan at 12-month follow-up. Results There was a significant difference between the preoperative (7.25 ± 0.8) and postoperative (3.1 ± 2.1) VAS scores (p < 0.0001). The ODI scale also demonstrated a statistically significant reduction from preoperative (56.3 ± 16.5) and postoperative (30.4 ± 19.3) scores (p < 0.0001). The SF-12 scores were significantly improved after ALIF salvage surgery: Physical Health Composite Score (32.18 ± 5.5 versus 41.07 ± 9.67, p = 0.0003) and Mental Health Composite Score (36.62 ± 12.25 versus 50.89 ± 10.86, p = 0.0001). Overall, 19 patients (95%) achieved successful fusion. Conclusions Overall, our results suggest that the ALIF procedure results not only in radiographic improvements in bony fusion but in significant improvements in the patient's physical and mental experience of pain secondary to lumbar pseudarthrosis. Future multicenter registry studies and randomized controlled trials should be conducted to confirm the long-term benefit of ALIF as a salvage option for failed posterior lumbar fusion. PMID:26835197

  3. Joint interpretation of geophysical data using Image Fusion techniques

    NASA Astrophysics Data System (ADS)

    Karamitrou, A.; Tsokas, G.; Petrou, M.

    2013-12-01

    Joint interpretation of geophysical data produced from different methods is a challenging area of research in a wide range of applications. In this work we apply several image fusion approaches to combine maps of electrical resistivity, electromagnetic conductivity, vertical gradient of the magnetic field, magnetic susceptibility, and ground penetrating radar reflections, in order to detect archaeological relics. We utilize data gathered from Arkansas University, with the support of the U.S. Department of Defense, through the Strategic Environmental Research and Development Program (SERDP-CS1263). The area of investigation is the Army City, situated in Riley Country of Kansas, USA. The depth of the relics is estimated about 30 cm from the surface, yet the surface indications of its existence are limited. We initially register the images from the different methods to correct from random offsets due to the use of hand-held devices during the measurement procedure. Next, we apply four different image fusion approaches to create combined images, using fusion with mean values, wavelet decomposition, curvelet transform, and curvelet transform enhancing the images along specific angles. We create seven combinations of pairs between the available geophysical datasets. The combinations are such that for every pair at least one high-resolution method (resistivity or magnetic gradiometry) is included. Our results indicate that in almost every case the method of mean values produces satisfactory fused images that corporate the majority of the features of the initial images. However, the contrast of the final image is reduced, and in some cases the averaging process nearly eliminated features that are fade in the original images. Wavelet based fusion outputs also good results, providing additional control in selecting the feature wavelength. Curvelet based fusion is proved the most effective method in most of the cases. The ability of curvelet domain to unfold the image in

  4. Application of rf-thruster technique for fusion plasma heating

    NASA Astrophysics Data System (ADS)

    Freisinger, J.; Loeb, H. W.

    On the basis of RF ion thruster devices, a family of RF injector generators (RIGs) for the heating of fusion plasmas up to the temperature of thermonuclear burn has been developed. Hydrogen ion beams of 10-40 amps can be accelerated by means of the RIGs to 30 kV, so that ion beam densities of more than 250 mA/sq cm are achievable at uniform profiles within only 1 deg of divergence angle. The use of electrodeless quartz ionizers yields a very high atomic ion fraction, low admixture of impurities, long lifetime, high reliability, simple mechanical elements, and easy control.

  5. Transforaminal Endoscopic Solution to a Kyphoplasty Complication: Technical Note.

    PubMed

    Wagner, Ralf; Telfeian, Albert E; Iprenburg, Menno; Krzok, Guntram; Gokaslan, Ziya; Choi, David B; Pucci, Francesco G; Oyelese, Adetkumbo

    2016-07-01

    Kyphoplasty is a minimally invasive spine surgical procedure performed to stabilize and treat the pain caused by a spine compression fracture. Complications are rare with kyphoplasty and include cement extrusion into the vertebral canal leading to spinal cord or nerve root compression. Herein, the authors present a case of a 72-year-old woman who presented with symptoms of a right L2 radiculopathy after a kyphoplasty procedure. Computed tomography imaging showed leakage of the kyphoplasty cement into the neural foramen above and medial to the right L2 pedicle. A transforaminal endoscopic surgical approach was used to remove the cement and decompress the L2 nerve. The patient's postoperative clinical course was uneventful. Clinicians should be aware that for the treatment of complications to vertebroplasty and kyphoplasty procedures, minimally invasive transforaminal endoscopic surgery is one option to avoid the destabilizing effects of laminectomy and facetectomy. PMID:27072335

  6. Improving image classification in a complex wetland ecosystem through image fusion techniques

    NASA Astrophysics Data System (ADS)

    Kumar, Lalit; Sinha, Priyakant; Taylor, Subhashni

    2014-01-01

    The aim of this study was to evaluate the impact of image fusion techniques on vegetation classification accuracies in a complex wetland system. Fusion of panchromatic (PAN) and multispectral (MS) Quickbird satellite imagery was undertaken using four image fusion techniques: Brovey, hue-saturation-value (HSV), principal components (PC), and Gram-Schmidt (GS) spectral sharpening. These four fusion techniques were compared in terms of their mapping accuracy to a normal MS image using maximum-likelihood classification (MLC) and support vector machine (SVM) methods. Gram-Schmidt fusion technique yielded the highest overall accuracy and kappa value with both MLC (67.5% and 0.63, respectively) and SVM methods (73.3% and 0.68, respectively). This compared favorably with the accuracies achieved using the MS image. Overall, improvements of 4.1%, 3.6%, 5.8%, 5.4%, and 7.2% in overall accuracies were obtained in case of SVM over MLC for Brovey, HSV, GS, PC, and MS images, respectively. Visual and statistical analyses of the fused images showed that the Gram-Schmidt spectral sharpening technique preserved spectral quality much better than the principal component, Brovey, and HSV fused images. Other factors, such as the growth stage of species and the presence of extensive background water in many parts of the study area, had an impact on classification accuracies.

  7. Optimized swimmer tracking system by a dynamic fusion of correlation and color histogram techniques

    NASA Astrophysics Data System (ADS)

    Benarab, D.; Napoléon, T.; Alfalou, A.; Verney, A.; Hellard, P.

    2015-12-01

    To design a robust swimmer tracking system, we took into account two well-known tracking techniques: the nonlinear joint transform correlation (NL-JTC) and the color histogram. The two techniques perform comparably well, yet they both have substantial limitations. Interestingly, they also seem to show some complementarity. The correlation technique yields accurate detection but is sensitive to rotation, scale and contour deformation, whereas the color histogram technique is robust for rotation and contour deformation but shows low accuracy and is highly sensitive to luminosity and confusing background colors. These observations suggested the possibility of a dynamic fusion of the correlation plane and the color scores map. Before this fusion, two steps are required. First is the extraction of a sub-plane of correlation that describes the similarity between the reference and target images. This sub-plane has the same size as the color scores map but they have different interval values. Thus, the second step is required which is the normalization of the planes in the same interval so they can be fused. In order to determine the benefits of this fusion technique, first, we tested it on a synthetic image containing different forms with different colors. We thus were able to optimize the correlation plane and color histogram techniques before applying our fusion technique to real videos of swimmers in international competitions. Last, a comparative study of the dynamic fusion technique and the two classical techniques was carried out to demonstrate the efficacy of the proposed technique. The criteria of comparison were the tracking percentage, the peak to correlation energy (PCE), which evaluated the sharpness of the peak (accuracy), and the local standard deviation (Local-STD), which assessed the noise in the planes (robustness).

  8. Transforaminal sacral approach for spinal anesthesia in orthopedic surgery: A novel approach.

    PubMed

    Sujay, Mysore; Madhavi, Santpur; Aravind, G; Hasan, Adil; Venugopalan, V M

    2014-01-01

    Regional anesthesia is preferred world-wide for its distinct advantages. The benefits of regional anesthesia in patients with comorbid conditions are well-established. The administration of regional anesthesia can sometimes pose a challenge to the anesthesiologist due to the structural abnormalities of the spine. The most common difficulty encountered for spinal anesthesia in our hospital (Nalgonda District) is skeletal fluorosis. Apart from the midline approach, paramedian, and Taylor's approaches are advocated for difficult scenarios. This article reports two orthopedic cases, conducted under a novel spinal anesthesia technique, i.e., transforaminal sacral approach under C-arm guidance with a successful outcome. The sacral foraminal subarachnoid block is a method to access the subarachnoid space through the upper posterior sacral foramina. PMID:25886238

  9. Transforaminal sacral approach for spinal anesthesia in orthopedic surgery: A novel approach

    PubMed Central

    Sujay, Mysore; Madhavi, Santpur; Aravind, G.; Hasan, Adil; Venugopalan, V. M.

    2014-01-01

    Regional anesthesia is preferred world-wide for its distinct advantages. The benefits of regional anesthesia in patients with comorbid conditions are well-established. The administration of regional anesthesia can sometimes pose a challenge to the anesthesiologist due to the structural abnormalities of the spine. The most common difficulty encountered for spinal anesthesia in our hospital (Nalgonda District) is skeletal fluorosis. Apart from the midline approach, paramedian, and Taylor's approaches are advocated for difficult scenarios. This article reports two orthopedic cases, conducted under a novel spinal anesthesia technique, i.e., transforaminal sacral approach under C-arm guidance with a successful outcome. The sacral foraminal subarachnoid block is a method to access the subarachnoid space through the upper posterior sacral foramina. PMID:25886238

  10. Using data mining techniques for building fusion models

    NASA Astrophysics Data System (ADS)

    Zhang, Zhongfei; Salerno, John J.; Regan, Maureen A.; Cutler, Debra A.

    2003-03-01

    Over the past decade many techniques have been developed which attempt to predict possible events through the use of given models or patterns of activity. These techniques work quite well given the case that one has a model or a valid representation of activity. However, in reality for the majority of the time this is not the case. Models that do exist, in many cases were hand crafted, required many man-hours to develop and they are very brittle in the dynamic world in which we live. Data mining techniques have shown some promise in providing a set of solutions. In this paper we will provide the details for our motivation, theory and techniques which we have developed, as well as the results of a set of experiments.

  11. Data Fusion for Combining Techniques to Detect and Size Surface and Near-Surface Defects

    SciTech Connect

    Edwards, R. S.; Dixon, S.; Sophian, A.; Tian, G. Y.

    2007-03-21

    In NDT it is important to have a high probability of detection and reliable sizing of defects in a sample. This can be gained by using several techniques, which leads to an increase in cost and time for testing. Another option is to use several techniques combined into a single probe, in which case data fusion for the techniques is possible. We report measurements using a dual probe containing a pair of electro-magnetic acoustic transducers generating and detecting low frequency broadband ultrasonic surface waves, combined with a pulsed eddy current probe. These two techniques are complementary but can be combined to work as competitive or cooperative sensors depending on the type of defect being investigated. Our work gives the depth of surface breaking defects by performing data fusion on certain features of data from each technique in a competitive sense, with data fusion by mathematical algorithm. Further analysis of the results using cooperative data fusion can give details of the depth and type of defect, for example surface breaking or near surface. The dual probe has been demonstrated on several samples, including aluminium and steel samples with several simulated defects on each side.

  12. Comparison of acid leaching and fusion techniques to determine uranium in soil samples by alpha spectrometry.

    PubMed

    Dirican, Abdullah; Şahin, Mihriban

    2016-03-01

    Dissolution of radionuclides of interest is an indispensable first step in the alpha spectrometric analysis of soil samples. In this study a uranium recovery method for the analysis of uranium isotopes in soil samples is presented. Two different soil sample dissolution techniques were used: digestion in open beaker and fusion. The results of these techniques were compared. Two proficiency test samples and one reference material prepared by the IAEA were analyzed. Better results were obtained by fusion dissolution technique but impurities were higher than with acid leaching. Results of two techniques were more or less similar within the uncertainty limits. The detection limit (a(#)) was evaluated as part of the quality control. PMID:26651172

  13. Fusion

    NASA Astrophysics Data System (ADS)

    Herman, Robin

    1990-10-01

    The book abounds with fascinating anecdotes about fusion's rocky path: the spurious claim by Argentine dictator Juan Peron in 1951 that his country had built a working fusion reactor, the rush by the United States to drop secrecy and publicize its fusion work as a propaganda offensive after the Russian success with Sputnik; the fortune Penthouse magazine publisher Bob Guccione sank into an unconventional fusion device, the skepticism that met an assertion by two University of Utah chemists in 1989 that they had created "cold fusion" in a bottle. Aimed at a general audience, the book describes the scientific basis of controlled fusion--the fusing of atomic nuclei, under conditions hotter than the sun, to release energy. Using personal recollections of scientists involved, it traces the history of this little-known international race that began during the Cold War in secret laboratories in the United States, Great Britain and the Soviet Union, and evolved into an astonishingly open collaboration between East and West.

  14. Percutaneous Transpedicular Interbody Fusion Technique in Percutaneous Pedicle Screw Stabilization for Pseudoarthrosis Following Pyogenic Spondylitis.

    PubMed

    Ikuta, Ko; Masuda, Keigo; Yonekura, Yutaka; Kitamura, Takahiro; Senba, Hideyuki; Shidahara, Satoshi

    2016-04-01

    This report introduces a percutaneous transpedicular interbody fusion (PTPIF) technique in posterior stabilization using percutaneous pedicle screws (PPSs). An 81-year-old man presented with pseudoarthrosis following pyogenic spondylitis 15 months before. Although no relapse of infection was found, he complained of obstinate low back pain and mild neurological symptoms. Radiological evaluations showed a pseudoarthrosis following pyogenic spondylitis at T11-12. Posterior stabilization using PPSs from Th9 to L2 and concomitant PTPIF using autologous iliac bone graft at T11-12 were performed. Low back pain and neurological symptoms were immediately improved after surgery. A solid interbody fusion at T11-12 was completed 9 months after surgery. The patient had no restriction of daily activity and could play golf at one year after surgery. PTPIF might be a useful option for perform segmental fusion in posterior stabilization using PPSs. PMID:27114777

  15. Percutaneous Transpedicular Interbody Fusion Technique in Percutaneous Pedicle Screw Stabilization for Pseudoarthrosis Following Pyogenic Spondylitis

    PubMed Central

    Masuda, Keigo; Yonekura, Yutaka; Kitamura, Takahiro; Senba, Hideyuki; Shidahara, Satoshi

    2016-01-01

    This report introduces a percutaneous transpedicular interbody fusion (PTPIF) technique in posterior stabilization using percutaneous pedicle screws (PPSs). An 81-year-old man presented with pseudoarthrosis following pyogenic spondylitis 15 months before. Although no relapse of infection was found, he complained of obstinate low back pain and mild neurological symptoms. Radiological evaluations showed a pseudoarthrosis following pyogenic spondylitis at T11–12. Posterior stabilization using PPSs from Th9 to L2 and concomitant PTPIF using autologous iliac bone graft at T11–12 were performed. Low back pain and neurological symptoms were immediately improved after surgery. A solid interbody fusion at T11–12 was completed 9 months after surgery. The patient had no restriction of daily activity and could play golf at one year after surgery. PTPIF might be a useful option for perform segmental fusion in posterior stabilization using PPSs. PMID:27114777

  16. Data fusion techniques for object space classification using airborne laser data and airborne digital photographs

    NASA Astrophysics Data System (ADS)

    Park, Joong Yong

    The objective of this research is to investigate possible strategies for the fusion of airborne laser data with passive optical data for object space classification. A significant contribution of our work is the development and implementation of a data-level fusion technique, direct digital image georeferencing (DDIG). In DDIG, we use navigation data from an integrated system (composed of global positioning system (GPS) and inertial measurement unit (IMU)) to project three-dimensional data points measured with the University of Florida's airborne laser swath mapping (ALSM) system onto digital aerial photographs. As an underlying math model, we use the familiar collinearity condition equations. After matching the ALSM object space points to their corresponding image space pixels, we resample the digital photographs using cubic convolution techniques. We call the resulting images pseudo-ortho-rectified images (PORI) because they are orthographic at the ground surface but still exhibit some relief displacement for elevated objects; and because they have been resampled using a interpolation technique. Our accuracy tests on these PORI images show that they are planimetrically correct to about 0.4 meters. This accuracy is sufficient to remove most of the effects of the central perspective projection and enable a meaningful fusion of the RGB data with the height and intensity data produced by the laser. PORI images may also be sufficiently accurate for many other mapping applications, and may in some applications be an attractive alternative to traditional photogrammetric techniques. A second contribution of our research is the development of several strategies for the fusion of data from airborne laser and camera systems. We have conducted our work within the sensor fusion paradigm formalized in the optical engineering community. Our work explores the fusion of these two types of data for precision mapping applications. Specifically, we combine three different types of

  17. Single stage transforaminal retrojugular tumor resection: The spinal keyhole for dumbbell tumors in the cervical spine

    PubMed Central

    Bobinski, Lukas; Henchoz, Yves; Sandu, Kishore; Duff, John Michael

    2015-01-01

    Background: Dumbbell tumors are defined as having an intradural and extradural component with an intermediate component within an expanded neural foramen. Complete resection of these lesions in the subaxial cervical spine is a challenge, and it has been achieved through a combined posterior/anterior or anterolateral approach. This study describes a single stage transforaminal retrojugular (TFR) approach for dumbbell tumors resection in the cervical spine. Methods: This is a retrospective review of a series of 17 patients treated for cervical benign tumors, 4 of which were “true” cervical dumbbell tumors operated by a simplified retrojugular approach. The TFR approach allows a single stage gross total resection of both the extraspinal and intraspinal/intradural components of the tumor, taking advantage of the expanded neural foramen. All patients were followed clinically and radiologically with magnetic resonance imaging (MRI). Results: Gross total resection was confirmed in all four patients by postoperative MRI. Minimal to no bone resection was performed. No fusion procedure was performed and no delayed instability was seen. At follow up, one patient had a persistent mild hand weakness and Horners syndrome following resection of a hemangioblastoma of the C8 nerve root. The other three patients were neurologically normal. Conclusions: The TFR approach appears to be a feasible surgical option for single stage resection in selective cases of dumbbell tumors of the cervical spine. PMID:25883845

  18. A New Grid based Ionosphere Algorithm for GAGAN using Data Fusion Technique (ISRO GIVE Model-Multi Layer Data Fusion)

    NASA Astrophysics Data System (ADS)

    Srinivasan, Nirmala; Ganeshan, A. S.; Mishra, Saumyaketu

    2012-07-01

    A New Grid based Ionosphere Algorithm for GAGAN using Data Fusion Technique (ISRO GIVE Model-Multi Layer Data Fusion) Saumyaketu Mishra, Nirmala S, A S Ganeshan ISRO Satellite Centre, Bangalore and Timothy Schempp, Gregory Um, Hans Habereder Raytheon Company Development of a region-specific ionosphere model is the key element in providing precision approach services for civil aviation with GAGAN (GPS Aided GEO Augmented Navigation). GAGAN is an Indian SBAS (Space Based Augmentation System) comprising of three segments; space segment (GEO and GPS), ground segment (15 Indian reference stations (INRES), 2 master control centers and 3 ground uplink stations) and user segment. The GAGAN system is intended to provide air navigation services for APV 1/1.5 precision approach over the Indian land mass and RNP 0.1 navigation service over Indian Flight Information Region (FIR), conforming to the standards of GNSS ICAO-SARPS. Ionosphere being largest source of error is of prime concern for a SBAS. India is a low latitude country, posing challenges for grid based ionosphere algorithm development; large spatial and temporal gradients, Equatorial anomaly, Depletions (bubbles), Scintillations etc. To meet the required GAGAN performance, it is necessary to develop and implement a best suitable ionosphere model, applicable for the Indian region as thin shell models like planar does not meet the requirement. ISRO GIVE Model - Multi Layer Data Fusion (IGM-MLDF) employs an innovative approach for computing the ionosphere corrections and confidences at pre-defined grid points at 350 Km shell height. Ionosphere variations over the Geo-magnetic equatorial regions shows peak electron density shell height variations from 200 km to 500 km, so single thin shell assumption at 350 km is not valid over Indian region. Hence IGM-MLDF employs innovative scheme of modeling at two shell heights. Through empirical analysis the shell heights of 250 km and 450 km are chosen. The ionosphere measurement

  19. Plasma diagnostic techniques in thermal-barrier tandem-mirror fusion experiments

    SciTech Connect

    Silver, E.H.; Clauser, J.F.; Carter, M.R.; Failor, B.H.; Foote, J.H.; Hornady, R.S.; James, R.A.; Lasnier, C.J.; Perkins, D.E.

    1986-08-29

    We review two classes of plasma diagnostic techniques used in thermal-barrier tandem-mirror fusion experiments. The emphasis of the first class is to study mirror-trapped electrons at the thermal-barrier location. The focus of the second class is to measure the spatial and temporal behavior of the plasma space potential at various axial locations. The design and operation of the instruments in these two categories are discussed and data that are representative of their performance is presented.

  20. Efficacy of transforaminal versus interspinous corticosteroid injectionin discal radiculalgia - a prospective, randomised, double-blind study.

    PubMed

    Thomas, E; Cyteval, C; Abiad, L; Picot, M C; Taourel, P; Blotman, F

    2003-10-01

    A prospective, randomised, double-blind study was carried out to compare the respective efficacies of transforaminal and interspinous epidural corticosteroid injections in discal radiculalgia. Thirty-one patients (18 females, 13 males) with discal radicular pain of less than 3 months' duration were consecutively randomised to receive either radio-guided transforaminal or blindly performed interspinous epidural corticosteroid injections. Post-treatment outcome was evaluated clinically at 6 and 30 days, and then at 6 months, but only by mailed questionnaire. At day 6, the between-group difference was significantly in favour of the transforaminal group with respect to Schober's index, finger-to-floor distance, daily activities, and work and leisure activities on the Dallas pain scale. At day 30, pain relief was significantly better in the transforaminal group. At month 6, answers to the mailed questionnaire still showed significantly better results for transforaminal injection concerning pain, daily activities, work and leisure activities and anxiety and depression, with a decline in the Roland-Morris score. In recent discal radiculalgia, the efficacy of radio-guided transforaminal epidural corticosteroid injections was higher than that obtained with blindly-performed interspinous injections. PMID:14579160

  1. Novel Hybrid Monte Carlo/Deterministic Technique for Shutdown Dose Rate Analyses of Fusion Energy Systems

    SciTech Connect

    Ibrahim, Ahmad M; Peplow, Douglas E.; Peterson, Joshua L; Grove, Robert E

    2013-01-01

    The rigorous 2-step (R2S) method uses three-dimensional Monte Carlo transport simulations to calculate the shutdown dose rate (SDDR) in fusion reactors. Accurate full-scale R2S calculations are impractical in fusion reactors because they require calculating space- and energy-dependent neutron fluxes everywhere inside the reactor. The use of global Monte Carlo variance reduction techniques was suggested for accelerating the neutron transport calculation of the R2S method. The prohibitive computational costs of these approaches, which increase with the problem size and amount of shielding materials, inhibit their use in the accurate full-scale neutronics analyses of fusion reactors. This paper describes a novel hybrid Monte Carlo/deterministic technique that uses the Consistent Adjoint Driven Importance Sampling (CADIS) methodology but focuses on multi-step shielding calculations. The Multi-Step CADIS (MS-CADIS) method speeds up the Monte Carlo neutron calculation of the R2S method using an importance function that represents the importance of the neutrons to the final SDDR. Using a simplified example, preliminarily results showed that the use of MS-CADIS enhanced the efficiency of the neutron Monte Carlo simulation of an SDDR calculation by a factor of 550 compared to standard global variance reduction techniques, and that the increase over analog Monte Carlo is higher than 10,000.

  2. Safe, Effective and Easily Reproducible Fusion Technique for CV Junction Instability

    PubMed Central

    Sannegowda, Raghavendra Bakki

    2015-01-01

    Introduction: The Craniovertebral junction (CVJ) refers to a bony enclosure where the occipital bone surrounds the foramen magnum, the atlas and the axis vertebrae. Because of the complexity of structures, CVJ instability is associated with diagnostic and therapeutic problems. Posterior CV fusion procedures have evolved a lot over the last couple of decades. There has been a lookout for one such surgical procedure which is inherently safe, simple, easily reproducible and biomechanically sound. In our study, we present the initial experience the cases of CV junction instrumentation using O-C1-C2 screw & rod construct operated by the author. Aims and Objectives: The current study is a descriptive analysis of the cases of CVJ instability treated by us with instrumentation using O-C1-C2 screw and rod construct fusion technique. Materials and Methods: It is a retrospective, analytical study in which cases of CV junction instability operated by the author between January 2010 to March 2014 were analysed using various clinical, radiological and outcome parameters. Conclusion: CV junction instrumentation using O-C1-C2 screw and rod construct fusion technique proved to be safe, effective, easily reproducible and biomechanically sound technique which can be adopted by all surgeons who may be at any stage of their learning curve. PMID:25954660

  3. Speckle noise reduction in ultrasound images using a discrete wavelet transform-based image fusion technique.

    PubMed

    Choi, Hyun Ho; Lee, Ju Hwan; Kim, Sung Min; Park, Sung Yun

    2015-01-01

    Here, the speckle noise in ultrasonic images is removed using an image fusion-based denoising method. To optimize the denoising performance, each discrete wavelet transform (DWT) and filtering technique was analyzed and compared. In addition, the performances were compared in order to derive the optimal input conditions. To evaluate the speckle noise removal performance, an image fusion algorithm was applied to the ultrasound images, and comparatively analyzed with the original image without the algorithm. As a result, applying DWT and filtering techniques caused information loss and noise characteristics, and did not represent the most significant noise reduction performance. Conversely, an image fusion method applying SRAD-original conditions preserved the key information in the original image, and the speckle noise was removed. Based on such characteristics, the input conditions of SRAD-original had the best denoising performance with the ultrasound images. From this study, the best denoising technique proposed based on the results was confirmed to have a high potential for clinical application. PMID:26405924

  4. No additional value of fusion techniques on anterior discectomy for neck pain: a systematic review.

    PubMed

    van Middelkoop, Marienke; Rubinstein, Sidney M; Ostelo, Raymond; van Tulder, Maurits W; Peul, Wilco; Koes, Bart W; Verhagen, Arianne P

    2012-11-01

    We aimed to assess the effects of additional fusion on surgical interventions to the cervical spine for patients with neck pain with or without radiculopathy or myelopathy by performing a systematic review. The search strategy outlined by the Cochrane Back Review Group (CBRG) was followed. The primary search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL and PEDro up to June 2011. Only randomised, controlled trials of adults with neck pain that evaluated at least one clinically relevant primary outcome measure (pain, functional status, recovery) were included. Two authors independently assessed the risk of bias by using the criteria recommended by the CBRG and extracted the data. Data were pooled using a random effects model. The quality of the evidence was rated using the GRADE method. In total, 10 randomised, controlled trials were identified comparing additional fusion upon anterior decompression techniques, including 2 studies with a low risk of bias. Results revealed no clinically relevant differences in recovery: the pooled risk difference in the short-term follow-up was -0.06 (95% confidence interval -0.22 to 0.10) and -0.07 (95% confidence interval -0.14 to 0.00) in the long-term follow-up. Pooled risk differences for pain and return to work all demonstrated no differences. There is no additional benefit of fusion techniques applied within an anterior discectomy procedure on pain, recovery and return to work. PMID:22818181

  5. Enamel fusion using a carbon dioxide laser: A technique for sealing pits and fissures

    SciTech Connect

    Walsh, L.J.; Perham, S.J. )

    1991-05-01

    The well-established enhanced resistance of lased enamel to demineralization is the basis for clinical application of the carbon dioxide laser to caries prevention. This in vitro study examined the effect of focused infrared laser radiation on sound enamel and early pit and fissure caries. Low power levels (2-5 W) induced localized melting and resolidification of enamel with little surface destruction. For sound fissures, fusion of enamel from the lateral walls of the fissure eliminated the fissure space, providing a sealant effect; while in carious fissures, carious enamel was vaporized and adjacent sound enamel fused to partially eliminate the defect. The technique for enamel fusion using CO2 lasers has potential application for sealing pits and fissures and producing physicochemical alterations in enamel which may have preventive benefits.

  6. Time-frequency data fusion technique with application to vibration signal analysis

    NASA Astrophysics Data System (ADS)

    Peng, Z. K.; Zhang, W. M.; Lang, Z. Q.; Meng, G.; Chu, F. L.

    2012-05-01

    To overcome the inherent deficiencies of conventional time-frequency analysis (TFA) methods, i.e., different TFA methods or the same TFA method with different control parameters will present different results for the same target signal, a novel scheme named as the time-frequency data fusion (TFDF) is developed in this study by extending the idea of data fusion technique. By combining the results produced by two or more different TFA methods, the TFDF technique can present a more accurate time-frequency presentation for the target signal than what can be achieved by any individual TFA method. Therefore, the TFDF has potential to render a significantly improved time-frequency representation and greatly facilitates extracting time-frequency features of target signals. This will promote the applications of TFA in engineering practices and make TFA methods more acceptable to field engineers. The effectiveness of the TFDF technique is validated by three numerical case studies and the analysis of a rubbing-impact signal collected from a rotor test rig.

  7. The Effects of a Forceful Transforaminal Epidural Steroid Injection on Radicular Pain: A Preliminary Study

    PubMed Central

    Byun, Jong Min; Woo, Jae Hee; Kim, Jin

    2014-01-01

    Background Lumbar transforaminal epidural steroid injections (TFESIs) are performed to provide symptom relief in patients with radicular pain. Recent articles suggested that injected volume itself have analgesic effects and higher volumes are associated with better outcomes. To date, few studies have been conducted to investigate the effects of volume. Therefore, well-designed controlled studies were necessary to confirm the effect of volume itself on pain relief. The purpose of this study was to examine the effectiveness of a forceful saline injection on lumbar TFESI using non-particulate steroids. Methods Fifty consecutive patients with lumbar radicular pain were enrolled. The participants were allocated into one of two groups: dexamethasone with volume (Group DV) and dexamethasone alone (Group DO). The volume was delivered by a forceful injection of 5ml of normal saline. The primary end-point for this study was a VAS pain score and modified MacNab score indicating the rate of effectiveness at the four-week follow-up. Results There were no significant post-procedural VAS differences between two groups (P = .252). The effectiveness rate among the patients was 47.8% in DV group, 34.8% in DO group, measured by modified MacNab score. The difference was not statistically significant (P = .117). Conclusions A forceful saline injection did not have a significant effect during the treatment of radicular pain. Further studies with greater volumes and with additional techniques would offer a more conclusive perspective. PMID:25317282

  8. Olive oil sensory defects classification with data fusion of instrumental techniques and multivariate analysis (PLS-DA).

    PubMed

    Borràs, Eva; Ferré, Joan; Boqué, Ricard; Mestres, Montserrat; Aceña, Laura; Calvo, Angels; Busto, Olga

    2016-07-15

    Three instrumental techniques, headspace-mass spectrometry (HS-MS), mid-infrared spectroscopy (MIR) and UV-visible spectrophotometry (UV-vis), have been combined to classify virgin olive oil samples based on the presence or absence of sensory defects. The reference sensory values were provided by an official taste panel. Different data fusion strategies were studied to improve the discrimination capability compared to using each instrumental technique individually. A general model was applied to discriminate high-quality non-defective olive oils (extra-virgin) and the lowest-quality olive oils considered non-edible (lampante). A specific identification of key off-flavours, such as musty, winey, fusty and rancid, was also studied. The data fusion of the three techniques improved the classification results in most of the cases. Low-level data fusion was the best strategy to discriminate musty, winey and fusty defects, using HS-MS, MIR and UV-vis, and the rancid defect using only HS-MS and MIR. The mid-level data fusion approach using partial least squares-discriminant analysis (PLS-DA) scores was found to be the best strategy for defective vs non-defective and edible vs non-edible oil discrimination. However, the data fusion did not sufficiently improve the results obtained by a single technique (HS-MS) to classify non-defective classes. These results indicate that instrumental data fusion can be useful for the identification of sensory defects in virgin olive oils. PMID:26948620

  9. Random sets technique for information fusion applied to estimation of brain functional images

    NASA Astrophysics Data System (ADS)

    Smith, Therese M.; Kelly, Patrick A.

    1999-05-01

    A new mathematical technique for information fusion based on random sets, developed and described by Goodman, Mahler and Nguyen (The Mathematics of Data Fusion, Kluwer, 1997) can be useful for estimation of functional brian images. Many image estimation algorithms employ prior models that incorporate general knowledge about sizes, shapes and locations of brain regions. Recently, algorithms have been proposed using specific prior knowledge obtained from other imaging modalities (for example, Bowsher, et al., IEEE Trans. Medical Imaging, 1996). However, there is more relevant information than is presently used. A technique that permits use of additional prior information about activity levels would improve the quality of prior models, and hence, of the resulting image estimate. The use of random sets provides this capability because it allows seemingly non-statistical (or ambiguous) information such as that contained in inference rules to be represented and combined with observations in a single statistical model, corresponding to a global joint density. This paper illustrates the use of this approach by constructing an example global joint density function for brain functional activity from measurements of functional activity, anatomical information, clinical observations and inference rules. The estimation procedure is tested on a data phantom with Poisson noise.

  10. Operation of lumbar zygoapophyseal joint cysts using a full-endoscopic interlaminar and transforaminal approach: prospective 2-year results of 74 patients.

    PubMed

    Komp, Martin; Hahn, Patrick; Ozdemir, Semih; Merk, Harry; Kasch, Richard; Godolias, Georgios; Ruetten, Sebastian

    2014-12-01

    In appropriate situations, extensive decompression with laminectomy often continues to be described as the method of choice for operations involving lumbar zygoapophyseal joint (z-joint) cysts. Tissue-sparing procedures are nevertheless becoming more common. Endoscopic techniques have become the standard procedures in many areas because of the advantages they offer in terms of surgical technique and in rehabilitation. One key aspect in spinal surgery was the development of instruments for sufficient bone resection carried out under continuous visual control. This enabled endoscopes to be used when operating on z-joint cysts. The objective of this prospective study was to examine the technical possibilities for the full-endoscopic interlaminar and transforaminal technique in lumbar z-joint cysts. A total of 74 patients were followed up for 2 years. The results show that 85% of the patients no longer have any leg pain or that the pain had been almost completely eliminated, and 11 % experience occasional pain. The complication rate was low. The full-endoscopic techniques brought advantages in the following areas: operation, complications, traumatization, and rehabilitation. The recorded results show that full-endoscopic resection of a z-joint cyst using an interlaminar and transforaminal approach provides an adequate and safe supplement, and is an alternative to conventional procedures when the indication criteria are fulfilled. It also offers the advantages of a minimally invasive intervention. PMID:24667524

  11. Removal of discal cyst using percutaneous working channel endoscope via transforaminal route

    PubMed Central

    Kim, Jin-Sung; Choi, Gun; Lee, Choon Dae

    2008-01-01

    Discal cyst is a very rare lesion that can cause refractory low back pain and radiating leg pain. Although there are some reports to remove this lesion, there has been no report of discal cyst removed by percutaneous endoscopic transforaminal approach. Two young patients manifested left gluteal and leg pain due to a discal cyst at L5–S1 level and L4–5 level, respectively. Percutaneous endoscopic transforaminal approach was performed to remove the discal cyst, achieving complete decompression of the nerve root. The symptom was relieved and the patient was discharged the next day. Percutaneous endoscopic transforaminal approach could be a good alternative option in selected cases for the treatment of lumbar discal cyst. PMID:19034535

  12. Encoding technique for high data compaction in data bases of fusion devices

    SciTech Connect

    Vega, J.; Cremy, C.; Sanchez, E.; Portas, A.

    1996-12-01

    At present, data requirements of hundreds of Mbytes/discharge are typical in devices such as JET, TFTR, DIII-D, etc., and these requirements continue to increase. With these rates, the amount of storage required to maintain discharge information is enormous. Compaction techniques are now essential to reduce storage. However, general compression techniques may distort signals, but this is undesirable for fusion diagnostics. We have developed a general technique for data compression which is described here. The technique, which is based on delta compression, does not require an examination of the data as in delayed methods. Delta values are compacted according to general encoding forms which satisfy a prefix code property and which are defined prior to data capture. Several prefix codes, which are bit oriented and which have variable code lengths, have been developed. These encoding methods are independent of the signal analog characteristics and enable one to store undistorted signals. The technique has been applied to databases of the TJ-I tokamak and the TJ-IU torsatron. Compaction rates of over 80{percent} with negligible computational effort were achieved. Computer programs were written in ANSI C, thus ensuring portability and easy maintenance. We also present an interpretation, based on information theory, of the high compression rates achieved without signal distortion. {copyright} {ital 1996 American Institute of Physics.}

  13. Application of Frechet and other random-set averaging techniques to fusion of information

    NASA Astrophysics Data System (ADS)

    Goodman, I. R.

    1998-07-01

    An obviously important aspect of target tracking, and more generally, data fusion, is the combination of those pieces of multi-source information deemed to belong together. Recently, it has been pointed out that a random set approach to target tracking and data fusion may be more appropriate rather than the standard point-vector estimate approach -- especially in the case of large inherent parameter errors. In addition, since many data fusion problems involve non-numerical linguistic descriptions, in the same spirit it is also desirable to be able to have a method which averages in some qualitative sense random sets which are non-numerically- valued, i.e., which take on propositions or events, such as 'the target appears in area A or C, given the weather conditions of yesterday and source 1' and 'the target appears in area A or B, given the weather conditions of today and source 2.' This leads to the fundamental problem of how best to define the expectation of a random set. To date, this open issue has only been considered for numerically-based random sets. This paper addresses this issue in part by proposing an approach which is actually algebraically-based, but also applicable to numerical-based random sets, and directly related to both the Frechet and the Aumann-Artstein-Vitale random set averaging procedures. The technique employs the concept of 'constant probability events,' which has also played a key role in the recent development of 'relational event algebra,' a new mathematical tool for representing various models in the form of various functions of probabilities.

  14. Outcomes of Microendoscopic Discectomy and Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation: A Comparative Retrospective Study

    PubMed Central

    Sinkemani, Arjun; Hong, Xin; Gao, Zeng-Xin; Zhuang, Su-Yang; Jiang, Zan-Li; Zhang, Shao-Dong; Bao, Jun-Ping; Zhu, Lei; Zhang, Pei; Xie, Xin-Hui; Wang, Feng

    2015-01-01

    Study Design Retrospective, case control evaluation of 86 patients who underwent microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of lumbar disc herniation (LDH). Purpose To evaluate the safety and the outcomes of MED and PTED for the treatment of LDH. Overview of Literature MED and PTED are minimally invasive surgical techniques for lower back pain. Studies to date have shown that MED and PTED are safe and effective treatment modalities for LDH. Methods A retrospective study was performed in patients with LDH treated with MED (n=50) and transforaminal endoscopic discectomy (PTED; n=36) in our hospital. All patients were followed-up with self-evaluation questionnaires, Oswestry disability index (ODI), medical outcomes study 36-item short form health survey and MacNab criteria. All the patients in both groups were followed up to 12 months after the operation. Results ODI questionnaire responses were not statistically different between the MED and PTED groups (53.00 vs. 48.72) before treatment. Average scores and minimal disability after 5 days to 12 months of follow-up were 4.96 in the MED group and 3.61 in the PTED group. According to MacNab criteria, 92.0% of the MED group and 94.4% of the PTED group had excellent or good results with no significant difference. Conclusions There was no significant difference between MED and PTED outcomes. Further large-scale, randomized studies with long-term follow-up are needed. PMID:26713113

  15. Beams, brightness, and background: Using active spectroscopy techniques for precision measurements in fusion plasma research

    SciTech Connect

    Thomas, Dan M.

    2012-05-15

    The use of an injected neutral beam-either a dedicated diagnostic beam or the main heating beams-to localize and enhance plasma spectroscopic measurements can be exploited for a number of key physics issues in magnetic confinement fusion research, yielding detailed profile information on thermal and fast ion parameters, the radial electric field, plasma current density, and turbulent transport. The ability to make these measurements has played a significant role in much of our recent progress in the scientific understanding of fusion plasmas. The measurements can utilize emission from excited state transitions either from plasma ions or from the beam atoms themselves. The primary requirement is that the beam 'probe' interacts with the plasma in a known fashion. Advantages of active spectroscopy include high spatial resolution due to the enhanced localization of the emission and the use of appropriate imaging optics, background rejection through the appropriate modulation and timing of the beam and emission collection/detection system, and the ability of the beam to populate emitter states that are either nonexistent or too dim to utilize effectively in the case of standard or passive spectroscopy. In addition, some active techniques offer the diagnostician unique information because of the specific quantum physics responsible for the emission. This paper will describe the general principles behind a successful active spectroscopic measurement, emphasize specific techniques that facilitate the measurements and include several successful examples of their implementation, briefly touching on some of the more important physics results. It concludes with a few remarks about the relevance and requirements of active spectroscopic techniques for future burning plasma experiments.

  16. Treatment of postherpetic neuralgia using a thoracic transforaminal epidural steroid injection.

    PubMed

    Mehta, Priyesh; Maher, Patrick; Singh, Jaspal Ricky

    2015-04-01

    A 64-year-old male patient with a history of herpes zoster exposure presented with severe, constant, burning pain in the left T10 dermatome consistent with postherpetic neuralgia. Previous treatment included oral and topical medications as well as an intercostal nerve block; however, these treatment options did not provide significant relief. The patient was treated with a single-level T10 thoracic transforaminal epidural steroid injection for refractory postherpetic neuralgia. He reported complete resolution of his symptoms at 2- and 12-week follow-ups. This case illustrates transforaminal epidural steroid injections may be a successful treatment option for postherpetic neuralgia. PMID:25479280

  17. Applying data fusion techniques for benthic habitat mapping and monitoring in a coral reef ecosystem

    NASA Astrophysics Data System (ADS)

    Zhang, Caiyun

    2015-06-01

    Accurate mapping and effective monitoring of benthic habitat in the Florida Keys are critical in developing management strategies for this valuable coral reef ecosystem. For this study, a framework was designed for automated benthic habitat mapping by combining multiple data sources (hyperspectral, aerial photography, and bathymetry data) and four contemporary imagery processing techniques (data fusion, Object-based Image Analysis (OBIA), machine learning, and ensemble analysis). In the framework, 1-m digital aerial photograph was first merged with 17-m hyperspectral imagery and 10-m bathymetry data using a pixel/feature-level fusion strategy. The fused dataset was then preclassified by three machine learning algorithms (Random Forest, Support Vector Machines, and k-Nearest Neighbor). Final object-based habitat maps were produced through ensemble analysis of outcomes from three classifiers. The framework was tested for classifying a group-level (3-class) and code-level (9-class) habitats in a portion of the Florida Keys. Informative and accurate habitat maps were achieved with an overall accuracy of 88.5% and 83.5% for the group-level and code-level classifications, respectively.

  18. Analysis of Inadvertent Intradiscal Injections during Lumbar Transforaminal Epidural Injection

    PubMed Central

    Lee, Sung Mun; Bae, Jin Hong

    2014-01-01

    Background Recently, there have been several case reports and retrospective studies about the incidence of intradiscal (ID) injection during transforaminal epidural steroid injection (TFESI). Inadvertent ID injection is not a rare complication, and it carries the risk of developing diskitis, although there has been no report of diskitis after TFESI. We prospectively evaluated the incidence of inadvertent ID injection during lumbar TFESI and analyzed the contributing factors. Methods Ten patients received 2-level TFESI, and the remaining 229 patients received 1-level TFESI. When successful TFESI was performed, 2 ml of contrast dye was injected under real-time fluoroscopy to check for any inadvertent ID spread. A musculoskeletal radiologist analyzed all magnetic resonance images (MRIs) of patients who demonstrated inadvertent ID injection. When reviewing MRIs, the intervertebral foramen level where ID injection occurred was carefully examined, and any anatomical structure which narrowing the foramen was identified. Results Among the 249 TFESI, we identified 6 ID injections; thus, there was an incidence of 2.4%. Four patients had isthmic spondylolisthesis, and the level of spondylolisthesis coincided with the level of ID injection. We further examined the right or left foramen of the spondylolisthesis level and identified the upward migrated disc material that was narrowing the foramen. Conclusions Inadvertent ID injection during TFESI is not infrequent, and pain physicians must pay close attention to the type and location of disc herniation. PMID:24748946

  19. A technique for thick polymer coating of inertial-confinement-fusion targets

    NASA Technical Reports Server (NTRS)

    Lee, M. C.; Feng, I.-A.; Wang, T. G.; Kim, H.-G.

    1983-01-01

    A technique to coat a stalk-mounted inertial-confinement fusion (ICF) target with a thick polymer layer has been successfully demonstrated. The polymer solution is first atomized, allowed to coalesce into a droplet, and positioned in a stable acoustic levitating field. The stalk-mounted ICF target is then moved into the acoustic field by manipulating a 3-D positioner to penetrate the surface membrane of the droplet, thus immersing the target in the levitated coating solution. The target inside the droplet is maintained at the center of the levitated liquid using the 3-D positional information provided by two orthogonally placed TV cameras until the drying process is completed. The basic components of the experimental apparatus, including an acoustic levitator, liquid sample deployment device, image acquisition instrumentation, and 3-D positioner, are briefly described.

  20. Fusion techniques using distributed Kalman filtering for detecting changes in systems

    NASA Technical Reports Server (NTRS)

    Belcastro, Celeste M.; Fischl, Robert; Kam, Moshe

    1991-01-01

    A comparison is made of the performances of two detection strategies that are based on different data fusion techniques. The strategies detect changes in a linear system. One detection strategy involves combining the estimates and error covariance matrices of distributed Kalman filters, generating a residual from the used estimates, comparing this residual to a threshold, and making a decision. The other detection strategy involves a distributed decision process in which estimates from distributed Kalman filters are used to generate distributed residuals which are compared locally to a threshold. Local decisions are made and these decisions are then fused into a global decision. The performances of each of these detection schemes are compared, and it is concluded that better performance is achieved when local decisions are made and then fused into a global decision.

  1. More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion: A review

    PubMed Central

    Epstein, Nancy E.

    2016-01-01

    Background: In the lumbar spine, do more nerve root injuries occur utilizing minimally invasive surgery (MIS) techniques versus open lumbar procedures? To answer this question, we compared the frequency of nerve root injuries for multiple open versus MIS operations including diskectomy, laminectomy with/without fusion addressing degenerative disc disease, stenosis, and/or degenerative spondylolisthesis. Methods: Several of Desai et al. large Spine Patient Outcomes Research Trial studies showed the frequency for nerve root injury following an open diskectomy ranged from 0.13% to 0.25%, for open laminectomy/stenosis with/without fusion it was 0%, and for open laminectomy/stenosis/degenerative spondylolisthesis with/without fusion it was 2%. Results: Alternatively, one study compared the incidence of root injuries utilizing MIS transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) techniques; 7.8% of PLIF versus 2% of TLIF patients sustained root injuries. Furthermore, even higher frequencies of radiculitis and nerve root injuries occurred during anterior lumbar interbody fusions (ALIFs) versus extreme lateral interbody fusions (XLIFs). These high frequencies were far from acceptable; 15.8% following ALIF experienced postoperative radiculitis, while 23.8% undergoing XLIF sustained root/plexus deficits. Conclusions: This review indicates that MIS (TLIF/PLIF/ALIF/XLIF) lumbar surgery resulted in a higher incidence of root injuries, radiculitis, or plexopathy versus open lumbar surgical techniques. Furthermore, even a cursory look at the XLIF data demonstrated the greater danger posed to neural tissue by this newest addition to the MIS lumbar surgical armamentariu. The latter should prompt us as spine surgeons to question why the XLIF procedure is still being offered to our patients? PMID:26904372

  2. Eye region-based fusion technique of thermal and dark visual images for human face recognition

    NASA Astrophysics Data System (ADS)

    Bhowmik, Mrinal Kanti; Bhattacharjee, Debotosh; Basu, Dipak Kumar; Nasipuri, Mita

    2012-07-01

    We present an approach for human face recognition using eye region extraction/replacement method under low illumination and varying expression conditions. For conducting experiments, two different sets of face images, namely visual and corresponding thermal, are used from Imaging, Robotics, and Intelligent Systems (IRIS) thermal/visual face data. A decomposition and reconstruction technique of Daubechies wavelet co-efficient (db4) is used to generate the fused image by replacing the eye region in the visual image with the same region from the corresponding thermal image. After that, independent component analysis over the natural logarithm domain (Log-ICA) is used for feature extraction/dimensionality reduction, and finally, a classifier is used to classify the fused face images. Two different image sets, i.e., training and test image sets, are mainly prepared using the IRIS thermal/visual face database for finding the accuracy of the proposed system. Experimental results show the proposed method is more efficient than other image fusion techniques which have used region extraction techniques for dark faces.

  3. Technique for gray-scale visual light and infrared image fusion based on non-subsampled shearlet transform

    NASA Astrophysics Data System (ADS)

    Kong, Weiwei

    2014-03-01

    A novel image fusion technique based on NSST (non-subsampled shearlet transform) is presented, aiming at resolving the fusion problem of spatially gray-scale visual light and infrared images. NSST, as a new member of MGA (multi-scale geometric analysis) tools, possesses not only flexible direction features and optimal shift-invariance, but much better fusion performance and lower computational costs compared with several current popular MGA tools such as NSCT (non-subsampled contourlet transform). We specifically propose new rules for the fusion of low and high frequency sub-band coefficients of source images in the second step of the NSST-based image fusion algorithm. First, the source images are decomposed into different scales and directions using NSST. Then, the model of region average energy (RAE) is proposed and adopted to fuse the low frequency sub-band coefficients of the gray-scale visual light and infrared images. Third, the model of local directional contrast (LDC) is given and utilized to fuse the corresponding high frequency sub-band coefficients. Finally, the final fused image is obtained by using inverse NSST to all fused sub-images. In order to verify the effectiveness of the proposed technique, several current popular ones are compared over three different publicly available image sets using four evaluation metrics, and the experimental results demonstrate that the proposed technique performs better in both subjective and objective qualities.

  4. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution.

    PubMed

    Godzik, Jakub; Ravindra, Vijay M; Ray, Wilson Z; Schmidt, Meic H; Bisson, Erica F; Dailey, Andrew T

    2015-08-01

    OBJECT The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. METHODS The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1-2 and C2-7 lordotic angles, C2-7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. RESULTS At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1-108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. CONCLUSIONS The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated with

  5. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution

    PubMed Central

    Godzik, Jakub; Ravindra, Vijay M.; Ray, Wilson Z.; Schmidt, Meic H.; Bisson, Erica F.; Dailey, Andrew T.

    2016-01-01

    Object The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. Methods The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1–2 and C2–7 lordotic angles, C2–7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. Results At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1–108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. Conclusions The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated

  6. Computational comparison of three posterior lumbar interbody fusion techniques by using porous titanium interbody cages with 50% porosity.

    PubMed

    Lee, Yung-Heng; Chung, Chi-Jen; Wang, Chih-Wei; Peng, Yao-Te; Chang, Chih-Han; Chen, Chih-Hsien; Chen, Yen-Nien; Li, Chun-Ting

    2016-04-01

    This study investigated the biomechanical response of porous cages and lumbar spine segments immediately after surgery and after bone fusion, in addition to the long-term effects of various posterior lumbar interbody fusion (PLIF) techniques, by using the finite element method. Lumbar L3-L4 models based on three PLIF techniques (a single cage at the center of the intervertebral space, a single cage half-anterior to the intervertebral space, and two cages bilateral to the intervertebral space) with and without bone ingrowth were used to determine the biomechanical response of porous cages and lumbar segments instrumented with porous titanium cages (cage porosity=50%, pore diameter=1mm). The results indicated that bone fusion enhanced the stability of the lumbar segments with porous cages without any posterior instrumentation and reduced the peak von Mises stress in the cortical bones and porous cages. Two cages placed bilateral to the intervertebral space achieved the highest structural stability in the lumbar segment and lowest von Mises stress in the cages under both bone fusion conditions. Under identical loading (2-Nm), the range of motion in the single cage at the center of the intervertebral space with bone fusion decreased by 11% (from 1.18° to 1.05°) during flexion and by 66.5% (from 4.46° to 1.5°) during extension in the single cage half-anterior to the intervertebral space with bone fusion compared with no-fusion models. Thus, two porous titanium cages with 50% porosity can achieve high stability of a lumbar segment with PLIF. If only one cage is available, placing the cage half-anterior to the intervertebral space is recommended for managing degenerated lumbar segments. PMID:26874064

  7. Phantom radiculitis effectively treated by fluoroscopically guided transforaminal epidural steroid injections.

    PubMed

    DeGregoris, Gerard; Diwan, Sudhir

    2010-01-01

    Lower back and extremity pain in the amputee patient can be challenging to classify and treat. Radicular compression in a patient with lower limb amputation may present as or be superimposed upon phantom limb pain, creating diagnostic difficulties. Both patients and physicians classically find it difficult to discern phantom sensation from phantom limb pain and stump pain; radicular compression is often not considered. Many studies have shown back pain to be a significant cause of pain in lower limb amputees, but sciatica has been rarely reported in amputees. We present a case of L4/5 radiculitis in an above-knee amputee presenting as phantom radiculitis. Our patient is a 67 year old gentleman with new onset 10/10 pain in a phantom extremity superimposed upon a 40 year history of previously stable phantom limb pain. MRI showed a central disc herniation at L4/5 with compression of the traversing left L4 nerve root. Two fluoroscopically guided left transforaminal epidural steroid injections at the level of the L4 and L5 spinal nerve roots totally alleviated his new onset pain. At one year post injection, his phantom radiculitis pain was completely gone, though his underlying phantom limb pain remained. Lumbar radiculitis in lower extremity amputee patients may be difficult to differentiate from baseline phantom limb pain. When conservative techniques fail, fluoroscopically guided spinal nerve injection may be valuable in determining the etiology of lower extremity pain. Our experience supports the notion that epidural steroid injections can effectively treat phantom lumbar radiculitis in lower extremity amputees. PMID:21102962

  8. Comparison of inert-gas-fusion and modified Kjeldahl techniques for determination of nitrogen in niobium alloys

    NASA Technical Reports Server (NTRS)

    Merkle, E. J.; Graab, J. W.; Davis, W. F.

    1974-01-01

    This report compares results obtained for the determination of nitrogen in a selected group of niobium-base alloys by the inert-gas-fusion and the Kjeldahl procedures. In the inert-gas-fusion procedure the sample is heated to approximately 2700 C in a helium atmosphere in a single-use graphite crucible. A platinum flux is used to facilitate melting of the sample. The Kjeldahl method consisted of a rapid decomposition with a mixture of hydrofluoric acid, phosphoric acid, and potassium chromate; distillation in the presence of sodium hydroxide; and highly sensitive spectrophotometry with nitroprusside-catalyzed indophenol. In the 30- to 80-ppm range, the relative standard deviation was 5 to 7 percent for the inert-gas-fusion procedure and 2 to 8 percent for the Kjeldahl procedure. The agreement of the nitrogen results obtained by the two techniques is considered satisfactory.

  9. Measurements of fusion neutron yields by neutron activation technique: Uncertainty due to the uncertainty on activation cross-sections

    NASA Astrophysics Data System (ADS)

    Stankunas, Gediminas; Batistoni, Paola; Sjöstrand, Henrik; Conroy, Sean

    2015-07-01

    The neutron activation technique is routinely used in fusion experiments to measure the neutron yields. This paper investigates the uncertainty on these measurements as due to the uncertainties on dosimetry and activation reactions. For this purpose, activation cross-sections were taken from the International Reactor Dosimetry and Fusion File (IRDFF-v1.05) in 640 groups ENDF-6 format for several reactions of interest for both 2.5 and 14 MeV neutrons. Activation coefficients (reaction rates) have been calculated using the neutron flux spectra at JET vacuum vessel, both for DD and DT plasmas, calculated by MCNP in the required 640-energy group format. The related uncertainties for the JET neutron spectra are evaluated as well using the covariance data available in the library. These uncertainties are in general small, but not negligible when high accuracy is required in the determination of the fusion neutron yields.

  10. Evaluation techniques and metrics for assessment of pan+MSI fusion (pansharpening)

    NASA Astrophysics Data System (ADS)

    Mercovich, Ryan A.

    2015-05-01

    Fusion of broadband panchromatic data with narrow band multispectral data - pansharpening - is a common and often studied problem in remote sensing. Many methods exist to produce data fusion results with the best possible spatial and spectral characteristics, and a number have been commercially implemented. This study examines the output products of 4 commercial implementations with regard to their relative strengths and weaknesses for a set of defined image characteristics and analyst use-cases. Image characteristics used are spatial detail, spatial quality, spectral integrity, and composite color quality (hue and saturation), and analyst use-cases included a variety of object detection and identification tasks. The imagery comes courtesy of the RIT SHARE 2012 collect. Two approaches are used to evaluate the pansharpening methods, analyst evaluation or qualitative measure and image quality metrics or quantitative measures. Visual analyst evaluation results are compared with metric results to determine which metrics best measure the defined image characteristics and product use-cases and to support future rigorous characterization the metrics' correlation with the analyst results. Because pansharpening represents a trade between adding spatial information from the panchromatic image, and retaining spectral information from the MSI channels, the metrics examined are grouped into spatial improvement metrics and spectral preservation metrics. A single metric to quantify the quality of a pansharpening method would necessarily be a combination of weighted spatial and spectral metrics based on the importance of various spatial and spectral characteristics for the primary task of interest. Appropriate metrics and weights for such a combined metric are proposed here, based on the conducted analyst evaluation. Additionally, during this work, a metric was developed specifically focused on assessment of spatial structure improvement relative to a reference image and

  11. Comparing fusion techniques for the ImageCLEF 2013 medical case retrieval task.

    PubMed

    G Seco de Herrera, Alba; Schaer, Roger; Markonis, Dimitrios; Müller, Henning

    2015-01-01

    Retrieval systems can supply similar cases with a proven diagnosis to a new example case under observation to help clinicians during their work. The ImageCLEFmed evaluation campaign proposes a framework where research groups can compare case-based retrieval approaches. This paper focuses on the case-based task and adds results of the compound figure separation and modality classification tasks. Several fusion approaches are compared to identify the approaches best adapted to the heterogeneous data of the task. Fusion of visual and textual features is analyzed, demonstrating that the selection of the fusion strategy can improve the best performance on the case-based retrieval task. PMID:24815543

  12. S3 Dorsal Root Ganglion/Nerve Root Stimulation for Refractory Postsurgical Perineal Pain: Technical Aspects of Anchorless Sacral Transforaminal Lead Placement

    PubMed Central

    Zuidema, X.; Breel, J.; Wille, F.

    2016-01-01

    Chronic perineal pain limits patients in physical and sexual activities, leading to social and psychological distress. In most cases, this pain develops after surgery in the urogenital area or as a consequence of trauma. Neuromodulation is one of the options in chronic postsurgical perineal pain treatment. We present a case of refractory perineal pain after right sided surgical resection of a Bartholin's cyst which was treated with third sacral nerve root/dorsal root ganglion stimulation using the transforaminal approach. We describe a new anchorless lead placement technique using a unique curved lead delivery sheath. We postulate that this new posterior foraminal technique of lead placement is simple, safe, and reversible and may lower the occurrence of lead related complications. PMID:27123351

  13. S3 Dorsal Root Ganglion/Nerve Root Stimulation for Refractory Postsurgical Perineal Pain: Technical Aspects of Anchorless Sacral Transforaminal Lead Placement.

    PubMed

    Zuidema, X; Breel, J; Wille, F

    2016-01-01

    Chronic perineal pain limits patients in physical and sexual activities, leading to social and psychological distress. In most cases, this pain develops after surgery in the urogenital area or as a consequence of trauma. Neuromodulation is one of the options in chronic postsurgical perineal pain treatment. We present a case of refractory perineal pain after right sided surgical resection of a Bartholin's cyst which was treated with third sacral nerve root/dorsal root ganglion stimulation using the transforaminal approach. We describe a new anchorless lead placement technique using a unique curved lead delivery sheath. We postulate that this new posterior foraminal technique of lead placement is simple, safe, and reversible and may lower the occurrence of lead related complications. PMID:27123351

  14. Femoral Head Allograft for First Metatarsal Phalangeal Joint Fusion Using a Reamer Technique to Limit Graft Length.

    PubMed

    McCammon, Matt; Brosky, Thomas A; Pinney, Sofie L

    2016-01-01

    The use of interpositional bone grafting for arthrodesis of the first metatarsophalangeal joint can be a technically challenging procedure. A fresh-frozen femoral head allograft can provide an appropriate graft for lengthening and ultimate fusion. It has been well-documented in published studies that larger grafts at this site increase the risk of complications. When the joint is resected in a "square" fashion, length is actually lost from the first metatarsal head. We present a technique using a reamer applied to 1 side of the graft and the first metatarsal head in a "cup-and-cone" fashion, thereby limiting the total length of the actual graft size. This technique allows for easy positioning and lengthening, increasing the chance of graft incorporation at the fusion sites. PMID:26952312

  15. Bilateral pulmonary emboli associated with intraoperative use of thrombin-based hemostatic matrix following lumbar spine interbody fusion.

    PubMed

    Wei, Zhikui; Elder, Benjamin D; Goodwin, C Rory; Witham, Timothy F

    2015-09-01

    Here we describe a patient with bilateral pulmonary emboli (PE) associated with thrombin-based hemostatic matrix (TBHM) use in the setting of a possible venous injury during transforaminal lumbar interbody fusion in the treatment of degenerative spondylolisthesis at L4-5. TBHM products are gelatin granules mixed with human or bovine thrombin. They have been used in a wide variety of surgical procedures to facilitate local hemostasis though their use is not without complications. This is the first reported patient, to our knowledge, with a TBHM-related PE following spinal fusion. As TBHM is a widely used intraoperative hemostatic agent, surgeons should be aware of the risk of TBHM-associated PE, particularly when there is the potential for intravascular injection or dissemination. While our experience indicates that common pharmacological prophylaxis such as subcutaneous heparin is likely ineffective in reducing occurrence of PE in the setting of TBHM use, the PE was successfully treated with standard systemic anticoagulation. The authors would also add that when iliac injury is encountered during discectomy or interbody fusion through a posterior approach, use of TBHM may be a life-saving technique. Postoperatively, vascular surgery consultation is recommended and consideration should be given to systemic anticoagulation. PMID:25943630

  16. Fusion of 3D models derived from TLS and image-based techniques for CH enhanced documentation

    NASA Astrophysics Data System (ADS)

    Bastonero, P.; Donadio, E.; Chiabrando, F.; Spanò, A.

    2014-05-01

    Recognizing the various advantages offered by 3D new metric survey technologies in the Cultural Heritage documentation phase, this paper presents some tests of 3D model generation, using different methods, and their possible fusion. With the aim to define potentialities and problems deriving from integration or fusion of metric data acquired with different survey techniques, the elected test case is an outstanding Cultural Heritage item, presenting both widespread and specific complexities connected to the conservation of historical buildings. The site is the Staffarda Abbey, the most relevant evidence of medieval architecture in Piedmont. This application faced one of the most topical architectural issues consisting in the opportunity to study and analyze an object as a whole, from twice location of acquisition sensors, both the terrestrial and the aerial one. In particular, the work consists in the evaluation of chances deriving from a simple union or from the fusion of different 3D cloudmodels of the abbey, achieved by multi-sensor techniques. The aerial survey is based on a photogrammetric RPAS (Remotely piloted aircraft system) flight while the terrestrial acquisition have been fulfilled by laser scanning survey. Both techniques allowed to extract and process different point clouds and to generate consequent 3D continuous models which are characterized by different scale, that is to say different resolutions and diverse contents of details and precisions. Starting from these models, the proposed process, applied to a sample area of the building, aimed to test the generation of a unique 3Dmodel thorough a fusion of different sensor point clouds. Surely, the describing potential and the metric and thematic gains feasible by the final model exceeded those offered by the two detached models.

  17. Clear Zone Formation around Screws in the Early Postoperative Stages after Posterior Lumbar Fusion Using the Cortical Bone Trajectory Technique

    PubMed Central

    Iwatsuki, Koichi; Ohnishi, Yu-Ichiro; Ohkawa, Toshika; Yoshimine, Toshiki

    2015-01-01

    Study Design Retrospective study. Purpose To evaluate the initial fixation using the cortical bone trajectory (CBT) technique for posterior lumbar fusion through assessment of the clear zones around the screws and the risk factors involved. Overview of Literature Postoperative radiolucent zones (clear zones) are an indicator of poor conventional pedicle screw fixation. Methods Between January 2013 and April 2014, 19 patients (8 men and 11 women) underwent posterior lumbar interbody fusion or posterior lumbar fusion using the CBT technique. A total of 109 screws were used for evaluation with measurement of the maximum insertional torque of last two screw rotations. Clear zone-positivity on plain radiographs was investigated 6 months after surgery. The relation between intraoperative insertional torque and clear zone-positivity was investigated by one-way analysis of variance. In addition, the correlation between clear zone-positivity and gender, age (<75 years old or >75 years old), or operative stabilization level (<2 or >3 vertebral levels) was evaluated using the chi-square test. Results Clear zones were observed around six screws (5.50%) in five patients (26.3%). The mean insertional torque (4.00±2.09 inlbs) of clear zone-positive screws was lower than that of clear zone-negative screws (8.12±0.50 in-lbs), but the difference was not significant. There was a significant correlation between clear zone-positivity and operative level of stabilization. Conclusions The low incidence of clear zone-positive screws indicates good initial fixation using the CBT technique. Multilevel fusions may be risk factors for clear zone generation. PMID:26713120

  18. An investigation of density measurement method for yarn-dyed woven fabrics based on dual-side fusion technique

    NASA Astrophysics Data System (ADS)

    Zhang, Rui; Xin, Binjie

    2016-08-01

    Yarn density is always considered as the fundamental structural parameter used for the quality evaluation of woven fabrics. The conventional yarn density measurement method is based on one-side analysis. In this paper, a novel density measurement method is developed for yarn-dyed woven fabrics based on a dual-side fusion technique. Firstly, a lab-used dual-side imaging system is established to acquire both face-side and back-side images of woven fabric and the affine transform is used for the alignment and fusion of the dual-side images. Then, the color images of the woven fabrics are transferred from the RGB to the CIE-Lab color space, and the intensity information of the image extracted from the L component is used for texture fusion and analysis. Subsequently, three image fusion methods are developed and utilized to merge the dual-side images: the weighted average method, wavelet transform method and Laplacian pyramid blending method. The fusion efficacy of each method is evaluated by three evaluation indicators and the best of them is selected to do the reconstruction of the complete fabric texture. Finally, the yarn density of the fused image is measured based on the fast Fourier transform, and the yarn alignment image could be reconstructed using the inverse fast Fourier transform. Our experimental results show that the accuracy of density measurement by using the proposed method is close to 99.44% compared with the traditional method and the robustness of this new proposed method is better than that of conventional analysis methods.

  19. Transforaminal Percutaneous Endoscopic Discectomy for Lumbar Disc Herniation in Parkinson's Disease: A Case-Control Study

    PubMed Central

    Giovannopoulou, Eirini; Charitoudis, George; Kazakos, Konstantinos

    2016-01-01

    Study Design A case-control study. Purpose To investigate the effectiveness of transforaminal percutaneous endoscopic discectomy (TPED) in Parkinson's disease (PD). Overview of Literature Patients with PD frequently suffer from radiculopathy and low back pain. Additionally, they demonstrate higher complication rates after open spine surgery. However, the clinical outcome of minimally invasive techniques for lumbar discectomy, such as TPED, have not been established for this population. Methods Patients diagnosed with lumbar disc hernia were divided into Group A (11 patients diagnosed with PD), and Group B (10 patients as the control, non-PD group). All patients underwent TPED. Indexes of visual analogue scale (VAS) for leg pain and Oswestry disability index (ODI) were assessed right before surgery and at six weeks, three months, six months and one year post-surgery. Results At the baseline visit, groups did not differ significantly with age (p=0.724), gender (p=0.835), level of operation (p=0.407), ODI (p=0.497) and VAS (p=0.772). Parkinson's patients had higher scores in ODI at every visit, but the outcome was statistically significant only at 3 months (p=0.004) and one year (p=0.007). Similarly, VAS measurements were higher at each time point, with the difference being significant at 3 (p<0.001), 6 (0.021), and 12 (p<0.001) months after surgery. At the end of a year of follow up, ODI was reduced by 49.6% (±16.7) in Group A and 59.2% (±8.0) in Group B (p=0.111), translating to a 79.5% (±13.0) and 91.5% (±4.1) average improvement in daily functionality (p=0.024). VAS was reduced by 59.1 mm (±11.8) in Group A and 62.2 mm (±7.4) in Group B (p=0.485), leading to an 85.3 % (±4.0) and 91.9% (±2.6) general improvement in leg pain (p<0.001). Conclusions Our data indicate that TPED led to satisfactory improvement in leg pain and daily living in PD patients a year after surgery. PMID:27559446

  20. A systematic review of minimally invasive sacroiliac joint fusion utilizing a lateral transarticular technique

    PubMed Central

    Heiney, Jake; Cher, Daniel

    2015-01-01

    Background A number of studies have been published regarding minimally invasive surgical (MIS) fusion of the sacroiliac (SI) joint using a lateral transarticular approach. Herein we report a systematic review and meta-analysis to summarize operative measures and clinical outcomes reported in published studies of MIS SI joint fusion. Methods The systematic review was done according to PRISMA standards. PubMed and EMBASE were searched using the terms sacroiliac joint AND fusion. Original peer-reviewed articles in the English language that reported clinical outcomes on at least 5 cases of MIS SI joint fusion using a lateral transarticular approach were included. Random effects meta-analysis (RMA) was performed on selected variables using the DerSimonian and Laird method, including operative measures, VAS SI joint pain ratings (0-10 scale) and Oswestry Disability Index (ODI). Mean and 95% confidence intervals (CI) were calculated and heterogeneity was assessed. Other findings were summarized qualitatively. Results A total of 18 articles met the inclusion criteria. After accounting for overlapping cohorts, 12 unique cohorts from 4 countries were extracted for a total of 432 subjects. The RMA mean (range) was 59 minutes (27-78) for procedure time, 36.9cc (10-70) for estimated blood loss and 1.7 days (range 0-7) for length of stay (LOS). The RMA mean [95% CI] pain score dropped by 5.2 points at 6 months and 5.3 points at 12 months (baseline score of 8.1 [7.8-8.4], 12-month score of 2.7 [2.1-3.3]), and a 24-month score of 2.0(1.4-2.5). ODI decreased by 31 points at 12 months (baseline score of 56.2 [51.0-61.5], 6-month score of 30.7 [21.8-39.6], and 12-month score of 25.1 [12.3-37.9]). Some estimates showed significant variation across studies and between the types of implants used. Other reported outcomes were supportive of the positive effects of SI joint fusion. Conclusion Published studies of MIS SI joint fusion using a lateral transarticular approach confirm its

  1. The Applications of Decision-Level Data Fusion Techniques in the Field of Multiuser Detection for DS-UWB Systems

    PubMed Central

    Gu, Yebo; Yang, Minglei; Shi, Zhenguo; Wu, Zhilu

    2015-01-01

    In this paper, the decision-level data fusion techniques are extended to the multiuser detection (MUD) field. Then two novel MUD algorithms, that is the chairman arbitrating decision-level fusion criterion (CA-DFC) based MUD algorithm and the veto logic decision-level fusion criterion (VL-DFC) based MUD algorithm, are proposed for DS-UWB communication systems. In CA-DFC based method, the chairman can make his arbitration among the preliminary decisions from sub-optimal detectors by his own rule. In the VL-DFC based method, the undetermined bits in these preliminary decisions are considered to construct a simplified solution space, and then the chairman can make his final decision within this space. Simulation results demonstrate that the performances of CA-DFC and VL-DFC based MUD algorithms are superior to those of other sub-optimal MUD algorithms, and even close to that of OMD. Moreover, both of these proposed algorithms have lower computational complexity than OMD, which reveals their efficiency. Compared with CA-DFC, VL-DFC based algorithm achieves a little improvement in its performance, at the cost of the increment in its computational complexity. Thus, they can be applied to different practical situations. PMID:26404273

  2. Fusion techniques for hybrid ground-penetrating radar: electromagnetic induction landmine detection systems

    NASA Astrophysics Data System (ADS)

    Laffin, Matt; Mohamed, Magdi A.; Etebari, Ali; Hibbard, Mark

    2010-04-01

    Hybrid ground penetrating radar (GPR) and electromagnetic induction (EMI) sensors have advanced landmine detection far beyond the capabilities of a single sensing modality. Both probability of detection (PD) and false alarm rate (FAR) are impacted by the algorithms utilized by each sensing mode and the manner in which the information is fused. Algorithm development and fusion will be discussed, with an aim at achieving a threshold probability of detection (PD) of 0.98 with a low false alarm rate (FAR) of less than 1 false alarm per 2 square meters. Stochastic evaluation of prescreeners and classifiers is presented with subdivisions determined based on mine type, metal content, and depth. Training and testing of an optimal prescreener on lanes that contain mostly low metal anti-personnel mines is presented. Several fusion operators for pre-screeners and classifiers, including confidence map multiplication, will be investigated and discussed for integration into the algorithm architecture.

  3. Advanced data visualization and sensor fusion: Conversion of techniques from medical imaging to Earth science

    NASA Technical Reports Server (NTRS)

    Savage, Richard C.; Chen, Chin-Tu; Pelizzari, Charles; Ramanathan, Veerabhadran

    1993-01-01

    Hughes Aircraft Company and the University of Chicago propose to transfer existing medical imaging registration algorithms to the area of multi-sensor data fusion. The University of Chicago's algorithms have been successfully demonstrated to provide pixel by pixel comparison capability for medical sensors with different characteristics. The research will attempt to fuse GOES (Geostationary Operational Environmental Satellite), AVHRR (Advanced Very High Resolution Radiometer), and SSM/I (Special Sensor Microwave Imager) sensor data which will benefit a wide range of researchers. The algorithms will utilize data visualization and algorithm development tools created by Hughes in its EOSDIS (Earth Observation SystemData/Information System) prototyping. This will maximize the work on the fusion algorithms since support software (e.g. input/output routines) will already exist. The research will produce a portable software library with documentation for use by other researchers.

  4. Advanced data visualization and sensor fusion: Conversion of techniques from medical imaging to Earth science

    NASA Technical Reports Server (NTRS)

    Savage, Richard C.; Chen, Chin-Tu; Pelizzari, Charles; Ramanathan, Veerabhadran

    1992-01-01

    Hughes Aircraft Company and the University of Chicago propose to transfer existing medical imaging registration algorithms to the area of multi-sensor data fusion. The University of Chicago's algorithms have been successfully demonstrated to provide pixel by pixel comparison capability for medical sensors with different characteristics. The research will attempt to fuse GOES, AVHRR, and SSM/I sensor data which will benefit a wide range of researchers. The algorithms will utilize data visualization and algorithm development tools created by Hughes in its EOSDIS prototyping. This will maximize the work on the fusion algorithms since support software (e.g. input/output routines) will already exist. The research will produce a portable software library with documentation for use by other researchers.

  5. Minimally Invasive Unilateral vs. Bilateral Pedicle Screw Fixation and Lumbar Interbody Fusion in Treatment of Multi-Segment Lumbar Degenerative Disorders

    PubMed Central

    Liu, Xiaoyang; Li, Guangrun; Wang, Jiefeng; Zhang, Heqing

    2015-01-01

    Background The choice for instrumentation with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in treatment of degenerative lumbar disorders (DLD) remains controversial. The goal of this study was to investigate clinical outcomes in consecutive patients with multi-segment DLD treated with unilateral pedicle screw (UPS) vs. bilateral pedicle screw (BPS) instrumented TLIF. Material/Methods Eighty-four consecutive patients who had multi-level MIS-TLIF were retrospectively reviewed. All data were collected to compare the clinical outcomes between the 2 groups. Results Both groups showed similar clinical function scores in VAS and ODI. The two groups differed significantly in operative time (P<0.001), blood loss (P<0.001), and fusion rate (P=0.043), respectively. Conclusions This study demonstrated similar clinical outcomes between UPS fixation and BPS procedure after MIS-TLIF for multi-level DLD. Moreover, UPS technique was superior in operative time and blood loss, but represented lower fusion rate than the BPS construct did. PMID:26603050

  6. Measuring fusion excitation functions with RIBs: A thorough analysis of the stacked target technique and the related problems

    SciTech Connect

    Fisichella, M. Di Pietro, A.; Figuera, P.; Marchetta, C.; Shotter, A. C.; Lattuada, M.; Torresi, D.; Privitera, V.; Romano, L.; Ruiz, C.; Zadro, M.

    2015-10-15

    The use of the stacked target technique to measure fusion cross-sections of reactions induced by low intensity radioactive beams offers considerable advantages since several reaction energies may be simultaneously measured. The main disadvantage of the method is the degradation of the beam quality as it passes through the stack due to statistical nature of energy loss processes and any non-uniformity of the stacked targets. This degradation can lead to ambiguities of associating effective beam energies to reaction product yields for the targets within the stack. A detailed investigation of these ambiguities has been performed and some of the obtained results are presented.

  7. Fabrication of cryogenic inertial-confinement-fusion targets using target free-fall technique. Report No. 2-82

    SciTech Connect

    Kim, K.; Murphy, M.J.

    1982-04-01

    Techniques for fabricating cryogenic inertial confinement fusion targets (i.e., spherical shells containing a uniform layer of DT ice) are investigated using target free-fall concept. Detection and characterization of the moving targets are effected by optoelectronic means, of which the principal is an RF ac-interferometer. This interferometer system demonstrates, for the first time, the speed capabilities of the phase-modulation ac-interferometry. New techiques developed for handling, holding, launching, and transporting targets are also described. Results obtained at both room and cryogenic temperatures are presented.

  8. Non-probabilistic information fusion technique for structural damage identification based on measured dynamic data with uncertainty

    NASA Astrophysics Data System (ADS)

    Wang, Xiao-Jun; Yang, Chen; Qiu, Zhi-Ping

    2013-04-01

    Based on measured natural frequencies and acceleration responses, a non-probabilistic information fusion technique is proposed for the structural damage detection by adopting the set-membership identification (SMI) and two-step model updating procedure. Due to the insufficiency and uncertainty of information obtained from measurements, the uncertain problem of damage identification is addressed with interval variables in this paper. Based on the first-order Taylor series expansion, the interval bounds of the elemental stiffness parameters in undamaged and damaged models are estimated, respectively. The possibility of damage existence (PoDE) in elements is proposed as the quantitative measure of structural damage probability, which is more reasonable in the condition of insufficient measurement data. In comparison with the identification method based on a single kind of information, the SMI method will improve the accuracy in damage identification, which reflects the information fusion concept based on the non-probabilistic set. A numerical example is performed to demonstrate the feasibility and effectiveness of the proposed technique.

  9. Single and Dual Drug Release Patterns from Shellac Wax-Lutrol Matrix Tablets Fabricated with Fusion and Molding Techniques

    PubMed Central

    Phaechamud, T.; Choncheewa, C.

    2015-01-01

    The objective of this investigation was to prepare the shellac wax matrix tablets by fusion and molding technique incorporated with Lutrol in different ratios to modify the hydrophobicity of matrix tablet. The matrix tablets with single drug were loaded either with propranolol hydrochloride or hydrochlorothiazide as hydrophilic and hydrophobic model drugs, and a dual drug formula was also prepared. The single and dual drug release patterns were studied in a dissolution apparatus using distilled water as medium. Propranolol hydrochloride released from matrix was easier than hydrochlorothiazide. Drug release from shellac wax matrix could be enhanced by incorporation of Lutrol. However retardation of drug release from some matrix tablets was evident for the systems that could form dispersion in the dissolution medium. The gel network from high content of Lutrol was hexagonal which was a dense and more compact structure than the other structures found when low amounts of Lutrol were present in the formula. Therefore, the formulae with high content of Lutrol could prolong drug release more efficiently than those containing low content of Lutrol. Hence shellac wax matrix could modulate the drug release with the addition of Lutrol. Sustainable dual drug release was also obtained from these developed matrix tablets. Thus shellac wax-Lutrol component could be used as a potential matrix tablet prepared with fusion and molding technique with excellent controlled drug release. PMID:25767320

  10. Development of a diagnostic technique based on Cherenkov effect for measurements of fast electrons in fusion devices.

    PubMed

    Plyusnin, V V; Jakubowski, L; Zebrowski, J; Duarte, P; Malinowski, K; Fernandes, H; Silva, C; Rabinski, M; Sadowski, M J

    2012-08-01

    A diagnostic technique based on the Cherenkov effect is proposed for detection and characterization of fast (super-thermal and runaway) electrons in fusion devices. The detectors of Cherenkov radiation have been specially designed for measurements in the ISTTOK tokamak. Properties of several materials have been studied to determine the most appropriate one to be used as a radiator of Cherenkov emission in the detector. This technique has enabled the detection of energetic electrons (70 keV and higher) and the determination of their spatial and temporal variations in the ISTTOK discharges. Measurement of hard x-ray emission has also been carried out in experiments for validation of the measuring capabilities of the Cherenkov-type detector and a high correlation was found between the data of both diagnostics. A reasonable agreement was found between experimental data and the results of numerical modeling of the runaway electron generation in ISTTOK. PMID:22938292

  11. Development of a diagnostic technique based on Cherenkov effect for measurements of fast electrons in fusion devices

    SciTech Connect

    Plyusnin, V. V.; Duarte, P.; Fernandes, H.; Silva, C.

    2012-08-15

    A diagnostic technique based on the Cherenkov effect is proposed for detection and characterization of fast (super-thermal and runaway) electrons in fusion devices. The detectors of Cherenkov radiation have been specially designed for measurements in the ISTTOK tokamak. Properties of several materials have been studied to determine the most appropriate one to be used as a radiator of Cherenkov emission in the detector. This technique has enabled the detection of energetic electrons (70 keV and higher) and the determination of their spatial and temporal variations in the ISTTOK discharges. Measurement of hard x-ray emission has also been carried out in experiments for validation of the measuring capabilities of the Cherenkov-type detector and a high correlation was found between the data of both diagnostics. A reasonable agreement was found between experimental data and the results of numerical modeling of the runaway electron generation in ISTTOK.

  12. Joining techniques for a reduced activation 12Cr steel for inertial fusion energy

    SciTech Connect

    Hunt, R. M.; El-Dasher, B.; Choi, B. W.; Torres, S. G.

    2014-10-01

    At Lawrence Livermore National Laboratory, we are developing a reduced activation ferritic martensitic steel that is based on the ferritic martensitic steel HT-9. As a part of the development of this steel, we tested a series of welding processes for characterization, including conventional welds (electron beam, tungsten inert gas, and laser) as well as solid-state welds (hot isostatic pressing). We also heat treated the joints at various temperatures between 750 °C and 1050 °C to find a suitable normalization scheme. The modified HT-9 reduced activation ferritic martensitic steel appears highly suitable to welding and diffusion bonding. All welds showed good quality fusion zones with insignificant cracking or porosity. Additionally, a heat treatment schedule of 950 °C for one hour caused minimal grain growth while still converging the hardness of the base metal with that of the fusion and heat-affected zones. Also, modified HT-9 diffusion bonds that were created at temperatures of at least 950 °C for two hours at 103 MPa had interface tensile strengths of greater than 600 MPa. The diffusion bonds showed no evidence of increased hardness nor void formation at the diffusion bonded interface.

  13. Development of Field-Reversed Configuration Plasma Gun Formation Techniques for Magnetized Target Fusion

    NASA Astrophysics Data System (ADS)

    Lynn, Alan; Gilmore, Mark; Wynkoop, Tyler; Intrator, Thomas; Weber, Thomas

    2012-10-01

    Magnetized Target Fusion (MTF) is an innovative approach for a relatively fast and cheap path to the production of fusion energy that utilizes magnetic confinement to assist in the compression of a hot plasma to thermonuclear conditions by an external driver. Los Alamos National Laboratory (LANL) is currently pursing demonstration of the MTF concept via compression of an FRC (field-reversed configuration) plasma by a metal liner z-pinch in conjunction with the Air Force Research Laboratory in Albuquerque, NM. A key physics issue for the FRC as an MTF target lies in the initial pre-ionization (PI) stage. The PI formation process determines the amount of magnetic flux that can be trapped to form the FRC. This trapped flux plays an important role in the FRC's final equilibrium, transport, and stability properties. It also provides the route to greatest potential gains in FRC lifetime, which is essential to provide enough time to translate and compress the FRC effectively. In conjunction with LANL we plan to test and characterize a new system to improve the initial PI plasma formation. This system will use an array of plasma guns to form the initial plasma. Initial characterization of the plasma gun behavior will be presented.

  14. Using Advanced Remote Sensing Data Fusion Techniques for Studying Earth Surface Processes and Hazards: A Landslide Detection Case Study

    NASA Astrophysics Data System (ADS)

    Hulslander, D.

    2014-12-01

    A major problem in earth surface process and hazards research is we have little to no knowledge of precisely where and when the next significant event may occur. This makes it nearly impossible to set up adequate instrumentation and observation ahead of time. Furthermore, it is not practical to overcome this challenge by instrumenting and observing everywhere all the time. We can't be everywhere and see everything. Remote sensing helps us to fill that gap with missions such as Landsat and WorldView2 offering regular global coverage. However, remote sensing systems for global monitoring have several inherent compromises. Tradeoffs must be made between data storage, processing capacity, spatial resolution, spectral resolution, and temporal resolution. Additionally, instruments and systems must be designed in advance and from a generalized standpoint to serve as many purposes as possible, often at the expense of high performance in specific tasks. Because of these practical constraints, when using remote sensing data to study earth surface processes it is critical to maximize signal content or information obtained from all available data. Several approaches, including multi-temporal data fusion, multi-sensor data fusion, and fusion with derivative products such as band ratios or vegetation indices can help expand how much information can be extracted from remote sensing acquisitions. Fused dataset results contain more coherent information than the sum of their individual constituents. Examples using Landsat and WorldView2 data in this study show this added information makes it possible to map earth surface processes and events, such as the 2011 Cinque Terre landslides, in a more automated and repeatable fashion over larger areas than is possible with manual imagery analysis techniques and with greater chance of successful detection.

  15. Manual-Protocol Inspired Technique for Improving Automated MR Image Segmentation during Label Fusion.

    PubMed

    Bhagwat, Nikhil; Pipitone, Jon; Winterburn, Julie L; Guo, Ting; Duerden, Emma G; Voineskos, Aristotle N; Lepage, Martin; Miller, Steven P; Pruessner, Jens C; Chakravarty, M Mallar

    2016-01-01

    Recent advances in multi-atlas based algorithms address many of the previous limitations in model-based and probabilistic segmentation methods. However, at the label fusion stage, a majority of algorithms focus primarily on optimizing weight-maps associated with the atlas library based on a theoretical objective function that approximates the segmentation error. In contrast, we propose a novel method-Autocorrecting Walks over Localized Markov Random Fields (AWoL-MRF)-that aims at mimicking the sequential process of manual segmentation, which is the gold-standard for virtually all the segmentation methods. AWoL-MRF begins with a set of candidate labels generated by a multi-atlas segmentation pipeline as an initial label distribution and refines low confidence regions based on a localized Markov random field (L-MRF) model using a novel sequential inference process (walks). We show that AWoL-MRF produces state-of-the-art results with superior accuracy and robustness with a small atlas library compared to existing methods. We validate the proposed approach by performing hippocampal segmentations on three independent datasets: (1) Alzheimer's Disease Neuroimaging Database (ADNI); (2) First Episode Psychosis patient cohort; and (3) A cohort of preterm neonates scanned early in life and at term-equivalent age. We assess the improvement in the performance qualitatively as well as quantitatively by comparing AWoL-MRF with majority vote, STAPLE, and Joint Label Fusion methods. AWoL-MRF reaches a maximum accuracy of 0.881 (dataset 1), 0.897 (dataset 2), and 0.807 (dataset 3) based on Dice similarity coefficient metric, offering significant performance improvements with a smaller atlas library (< 10) over compared methods. We also evaluate the diagnostic utility of AWoL-MRF by analyzing the volume differences per disease category in the ADNI1: Complete Screening dataset. We have made the source code for AWoL-MRF public at: https://github.com/CobraLab/AWoL-MRF. PMID:27486386

  16. Using Geostatistical Data Fusion Techniques and MODIS Data to Upscale Simulated Wheat Yield

    NASA Astrophysics Data System (ADS)

    Castrignano, A.; Buttafuoco, G.; Matese, A.; Toscano, P.

    2014-12-01

    Population growth increases food request. Assessing food demand and predicting the actual supply for a given location are critical components of strategic food security planning at regional scale. Crop yield can be simulated using crop models because is site-specific and determined by weather, management, length of growing season and soil properties. Crop models require reliable location-specific data that are not generally available. Obtaining these data at a large number of locations is time-consuming, costly and sometimes simply not feasible. An upscaling method to extend coverage of sparse estimates of crop yield to an appropriate extrapolation domain is required. This work is aimed to investigate the applicability of a geostatistical data fusion approach for merging remote sensing data with the predictions of a simulation model of wheat growth and production using ground-based data. The study area is Capitanata plain (4000 km2) located in Apulia Region, mostly cropped with durum wheat. The MODIS EVI/NDVI data products for Capitanata plain were downloaded from the Land Processes Distributed Active Archive Center (LPDAAC) remote for the whole crop cycle of durum wheat. Phenological development, biomass growth and grain quantity of durum wheat were simulated by the Delphi system, based on a crop simulation model linked to a database including soil properties, agronomical and meteorological data. Multicollocated cokriging was used to integrate secondary exhaustive information (multi-spectral MODIS data) with primary variable (sparsely distributed biomass/yield model predictions of durum wheat). The model estimates looked strongly spatially correlated with the radiance data (red and NIR bands) and the fusion data approach proved to be quite suitable and flexible to integrate data of different type and support.

  17. Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself: biomechanical analysis using finite element

    NASA Astrophysics Data System (ADS)

    Park, Joon-Hee; Kim, Ho-Joong; Kang, Kyoung-Tak; Kim, Ka-yeon; Chun, Heoung-Jae; Moon, Seong-Hwan; Lee, Hwan-Mo

    2010-03-01

    The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.

  18. Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself: biomechanical analysis using finite element

    NASA Astrophysics Data System (ADS)

    Park, Joon-Hee; Kim, Ho-Joong; Kang, Kyoung-Tak; Kim, Ka-Yeon; Chun, Heoung-Jae; Moon, Seong-Hwan; Lee, Hwan-Mo

    2009-12-01

    The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.

  19. Development of laser-based techniques for in situ characterization of the first wall in ITER and future fusion devices

    NASA Astrophysics Data System (ADS)

    Philipps, V.; Malaquias, A.; Hakola, A.; Karhunen, J.; Maddaluno, G.; Almaviva, S.; Caneve, L.; Colao, F.; Fortuna, E.; Gasior, P.; Kubkowska, M.; Czarnecka, A.; Laan, M.; Lissovski, A.; Paris, P.; van der Meiden, H. J.; Petersson, P.; Rubel, M.; Huber, A.; Zlobinski, M.; Schweer, B.; Gierse, N.; Xiao, Q.; Sergienko, G.

    2013-09-01

    Analysis and understanding of wall erosion, material transport and fuel retention are among the most important tasks for ITER and future devices, since these questions determine largely the lifetime and availability of the fusion reactor. These data are also of extreme value to improve the understanding and validate the models of the in vessel build-up of the T inventory in ITER and future D-T devices. So far, research in these areas is largely supported by post-mortem analysis of wall tiles. However, access to samples will be very much restricted in the next-generation devices (such as ITER, JT-60SA, W7-X, etc) with actively cooled plasma-facing components (PFC) and increasing duty cycle. This has motivated the development of methods to measure the deposition of material and retention of plasma fuel on the walls of fusion devices in situ, without removal of PFC samples. For this purpose, laser-based methods are the most promising candidates. Their feasibility has been assessed in a cooperative undertaking in various European associations under EFDA coordination. Different laser techniques have been explored both under laboratory and tokamak conditions with the emphasis to develop a conceptual design for a laser-based wall diagnostic which is integrated into an ITER port plug, aiming to characterize in situ relevant parts of the inner wall, the upper region of the inner divertor, part of the dome and the upper X-point region.

  20. Techniques For Injection Of Pre-Charaterized Dust Into The Scrape Off Layer Of Fusion Plasma

    SciTech Connect

    Roquemore, A. L.; John, B.; Friesen, F.; Hartzfeld, K.; Mansfield, D. K.

    2011-07-21

    Introduction of micron-sized dust into the scrape-off layer (SOL) of a plasma has recently found many applications aimed primarily at determining dust behavior in future fusion reactors. The dust particles are typically composed of materials intrinsic to a fusion reactor. On DIII-D and TEXTOR carbon dust has been introduced into the SOL using a probe inserted from below into the divertor region. On NSTX, both Li and tungsten dust have been dropped from the top of the machine into the SOL throughout the duration of a discharge, by utilizing a vibrating piezoelectric based particle dropper. The original particle dropper was developed to inject passivated Li powder {approx} 40 {mu}m in diameter into the SOL to enhance plasma performance. A simplified version of the dropper was developed to introduce trace amounts of tungsten powder for only a few discharges, thus not requiring a large powder reservoir. The particles emit visible light from plasma interactions and can be tracked by either spectroscopic means or by fast frame rate visible cameras. This data can then be compared with dust transport codes such as DUSTT to make predictions of dust behavior in next-step devices such as ITER. For complete modeling results, it is desired to be able to inject pre-characterized dust particles in the SOL at various known poloidal locations, including near the vessel midplane. Purely mechanical methods of injecting particles are presently being studied using a modified piezoelectric-based powder dropper as a particle source and one of several piezo-based transducers to deflect the particles into the SOL. Vibrating piezo fans operating at 60 Hz with a deflection of {+-}2.5 cm can impart a significant horizontal boost in velocity. The highest injection velocities are expected from rotating paddle wheels capable of injecting particles at 10's of meters per second depending primarily on the rotation velocity and diameter of the wheel. Several injection concepts have been tested and

  1. Manual-Protocol Inspired Technique for Improving Automated MR Image Segmentation during Label Fusion

    PubMed Central

    Bhagwat, Nikhil; Pipitone, Jon; Winterburn, Julie L.; Guo, Ting; Duerden, Emma G.; Voineskos, Aristotle N.; Lepage, Martin; Miller, Steven P.; Pruessner, Jens C.; Chakravarty, M. Mallar

    2016-01-01

    Recent advances in multi-atlas based algorithms address many of the previous limitations in model-based and probabilistic segmentation methods. However, at the label fusion stage, a majority of algorithms focus primarily on optimizing weight-maps associated with the atlas library based on a theoretical objective function that approximates the segmentation error. In contrast, we propose a novel method—Autocorrecting Walks over Localized Markov Random Fields (AWoL-MRF)—that aims at mimicking the sequential process of manual segmentation, which is the gold-standard for virtually all the segmentation methods. AWoL-MRF begins with a set of candidate labels generated by a multi-atlas segmentation pipeline as an initial label distribution and refines low confidence regions based on a localized Markov random field (L-MRF) model using a novel sequential inference process (walks). We show that AWoL-MRF produces state-of-the-art results with superior accuracy and robustness with a small atlas library compared to existing methods. We validate the proposed approach by performing hippocampal segmentations on three independent datasets: (1) Alzheimer's Disease Neuroimaging Database (ADNI); (2) First Episode Psychosis patient cohort; and (3) A cohort of preterm neonates scanned early in life and at term-equivalent age. We assess the improvement in the performance qualitatively as well as quantitatively by comparing AWoL-MRF with majority vote, STAPLE, and Joint Label Fusion methods. AWoL-MRF reaches a maximum accuracy of 0.881 (dataset 1), 0.897 (dataset 2), and 0.807 (dataset 3) based on Dice similarity coefficient metric, offering significant performance improvements with a smaller atlas library (< 10) over compared methods. We also evaluate the diagnostic utility of AWoL-MRF by analyzing the volume differences per disease category in the ADNI1: Complete Screening dataset. We have made the source code for AWoL-MRF public at: https://github.com/CobraLab/AWoL-MRF. PMID

  2. New model for cardiomyocyte sheet transplantation using a virus-cell fusion technique

    PubMed Central

    Takahashi, Yuto; Tomotsune, Daihachiro; Takizawa, Sakiko; Yue, Fengming; Nagai, Mika; Yokoyama, Tadayuki; Hirashima, Kanji; Sasaki, Katsunori

    2015-01-01

    AIM: To facilitate close contacts between transplanted cardiomyocytes and host skeletal muscle using cell fusion mediated by hemagglutinating virus of Japan envelope (HVJ-E) and tissue maceration. METHODS: Cardiomyocytes (1.5 × 106) from fetal rats were first cultured. After proliferation, some cells were used for fusion with adult muscle fibers using HVJ-E. Other cells were used to create cardiomyocyte sheets (area: about 3.5 cm2 including 2.1 × 106 cells), which were then treated with Nile blue, separated, and transplanted between the latissimus dorsi and intercostal muscles of adult rats with four combinations of HVJ-E and/or NaOH maceration: G1: HVJ-E(+), NaOH(+), Cardiomyocytes(+); G2: HVJ-E(-), NaOH(+), Cardiomyocytes(+); G3: HVJ-E(+), NaOH(-), Cardiomyocytes(+); G4: HVJ-E(-), NaOH(-), Cardiomyocytes(-). At 1 and 2 wk after transplantation, the four groups were compared by detection of beating domains, motion images using moving target analysis software, action potentials, gene expression of MLC-2v and Mesp1 by reverse transcription-polymerase chain reaction, hematoxylin-eosin staining, and immunostaining for cardiac troponin and skeletal myosin. RESULTS: In vitro cardiomyocytes were fused with skeletal muscle fibers using HVJ-E. Cardiomyocyte sheets remained in the primary transplanted sites for 2 wk. Although beating domains were detected in G1, G2, and G3 rats, G1 rats prevailed in the number, size, motion image amplitudes, and action potential compared with G2 and G3 rats. Close contacts were only found in G1 rats. At 1 wk after transplantation, the cardiomyocyte sheets showed adhesion at various points to the myoblast layer in the latissimus dorsi muscle. At 2 wk after transplantation, close contacts were seen over a broad area. Part of the skeletal muscle sarcoplasma seemed to project into the myocardiocyte plasma and some nuclei appeared to share both sarcoplasmas. CONCLUSION: The present results show that close contacts were acquired and facilitated

  3. Improved prediction of drug-target interactions using regularized least squares integrating with kernel fusion technique.

    PubMed

    Hao, Ming; Wang, Yanli; Bryant, Stephen H

    2016-02-25

    Identification of drug-target interactions (DTI) is a central task in drug discovery processes. In this work, a simple but effective regularized least squares integrating with nonlinear kernel fusion (RLS-KF) algorithm is proposed to perform DTI predictions. Using benchmark DTI datasets, our proposed algorithm achieves the state-of-the-art results with area under precision-recall curve (AUPR) of 0.915, 0.925, 0.853 and 0.909 for enzymes, ion channels (IC), G protein-coupled receptors (GPCR) and nuclear receptors (NR) based on 10 fold cross-validation. The performance can further be improved by using a recalculated kernel matrix, especially for the small set of nuclear receptors with AUPR of 0.945. Importantly, most of the top ranked interaction predictions can be validated by experimental data reported in the literature, bioassay results in the PubChem BioAssay database, as well as other previous studies. Our analysis suggests that the proposed RLS-KF is helpful for studying DTI, drug repositioning as well as polypharmacology, and may help to accelerate drug discovery by identifying novel drug targets. PMID:26851083

  4. Identification of direct targets of plant transcription factors using the GR fusion technique.

    PubMed

    Yamaguchi, Nobutoshi; Winter, Cara M; Wellmer, Frank; Wagner, Doris

    2015-01-01

    The glucocorticoid receptor-dependent activation of plant transcription factors has proven to be a powerful tool for the identification of their direct target genes. In the absence of the synthetic steroid hormone dexamethasone (dex), transcription factors fused to the hormone-binding domain of the glucocorticoid receptor (TF-GR) are held in an inactive state, due to their cytoplasmic localization. This requires physical interaction with the heat shock protein 90 (HSP90) complex. Hormone binding leads to disruption of the interaction between GR and HSP90 and allows TF-GR fusion proteins to enter the nucleus. Once inside the nucleus, they bind to specific DNA sequences and immediately activate or repress expression of their targets. This system is well suited for the identification of direct target genes of transcription factors in plants, as (A) there is little basal protein activity in the absence of dex, (B) steroid application leads to rapid transcription factor activation, (C) no side effects of dex treatment are observed on the physiology of the plant, and (D) secondary effects of transcription factor activity can be eliminated by simultaneous application of an inhibitor of protein biosynthesis, cycloheximide (cyc). In this chapter, we describe detailed protocols for the preparation of plant material, for dex and cyc treatment, for RNA extraction, and for the PCR-based or genome-wide identification of direct targets of transcription factors fused to GR. PMID:25757770

  5. Monitoring the total organic carbon concentrations in a lake with the integrated data fusion and machine-learning (IDFM) technique

    NASA Astrophysics Data System (ADS)

    Chang, Ni-Bin; Vannah, Benjamin

    2012-10-01

    The concentration of total organic carbon (TOC) in surface waters is subject to seasonal variation, as well as abrupt changes in concentration due to events. In drinking water treatment, TOC is a precursor to disinfection byproducts such as total trihalomethanes (TTHM). With the aid of an early warning system for the detection of TOC concentrations, water treatment operators could make more informed decisions and adjust the treatment processes to minimize the generation of disinfection byproducts. In this paper, a near real-time monitoring system is explored using the Integrated Data Fusion and Machine-learning (IDFM) technique to predict the spatial distribution of TOC in a lake based upon surface reflectance data from satellite imagery. Landsat 5 TM and MODIS Terra satellite imagery can be acquired free of charge, yet MODIS has coarse spatial resolution, while Landsat has a lengthy 16 day revisit time. This difficulty is solved using data fusion algorithms to fuse the fine spatial resolution of Landsat with the daily revisit time of MODIS to generate a synthetic image with both high spatial and temporal resolution. To demonstrate the capabilities of IDFM, this case study uses the fused surface reflectance band data and applied machine-learning techniques to reconstruct the spatiotemporal distribution of TOC in Harsha Lake, which serves as the source water intake for the McEwen Water Treatment Plant in Ohio. The results of this application of IDFM were analyzed using 4 statistical indices, which indicated that the Artificial Neural Network model is capable of reconstructing TOC concentrations throughout the lake.

  6. The Effect and Feasibility Study of Transforaminal Percutaneous Endoscopic Lumbar Discectomy Via Superior Border of Inferior Pedicle Approach for Down-Migrated Intracanal Disc Herniations

    PubMed Central

    Ying, Jinwei; Huang, Kelun; Zhu, Minyu; Zhou, Beibei; Wang, Yu; Chen, Bi; Teng, Honglin

    2016-01-01

    Abstract Transforaminal percutaneous endoscopic lumbar discectomy (PELD) is gradually regarded as an effective alternative to posterior open surgery. However, migrated herniations bring a great technical challenge even for experienced surgeons due to the absence of the appropriate approaching guideline. We aimed to describe a safe and effective approaching technique for the removal of down-migrations on the basis of the clinical outcomes and complications compared with the conventional approaching method. A total of 45 patients recommended to single-level PELD with foraminoplasty were randomly divided into 2 groups, group A received foraminoplasty via upper border of inferior pedicle, group B was approached through the common transforaminal route. The clinical outcomes were evaluated by Visual Analog Scale (VAS) for leg pain and Oswestry Disability Index (ODI) scores. Then participants were classified into 2 types of migrations (high-grade and low-grade) based on the extent of migration presented on preoperative magnetic resonance imaging (MRI). The various comparisons between the 2 surgical techniques were analyzed. The postoperative VAS and ODI scores significantly decreased in both of the 2 groups after surgery (P < 0.001). The follow-up continued 1 year. With increasing length of follow-up, the disparities in clinical outcomes between the 2 groups were gradually narrowing and there was no significant difference at the end of follow-up (P = 0.32; P = 0.46). There were no differences in the operation time and duration of hospital stay (P = 0.36; P = 0.08). The highly migration group in group B showed a significant longer operation time (P = 0.02), but the extent of migration did not have a significant influence on the operation time in group A with the modified approach (P = 0.19). There were no apparent approach-related complications in group A during the procedure and follow-up period. Foraminoplastic-PELD via upper border of

  7. The Effect and Feasibility Study of Transforaminal Percutaneous Endoscopic Lumbar Discectomy Via Superior Border of Inferior Pedicle Approach for Down-Migrated Intracanal Disc Herniations.

    PubMed

    Ying, Jinwei; Huang, Kelun; Zhu, Minyu; Zhou, Beibei; Wang, Yu; Chen, Bi; Teng, Honglin

    2016-02-01

    Transforaminal percutaneous endoscopic lumbar discectomy (PELD) is gradually regarded as an effective alternative to posterior open surgery. However, migrated herniations bring a great technical challenge even for experienced surgeons due to the absence of the appropriate approaching guideline. We aimed to describe a safe and effective approaching technique for the removal of down-migrations on the basis of the clinical outcomes and complications compared with the conventional approaching method.A total of 45 patients recommended to single-level PELD with foraminoplasty were randomly divided into 2 groups, group A received foraminoplasty via upper border of inferior pedicle, group B was approached through the common transforaminal route. The clinical outcomes were evaluated by Visual Analog Scale (VAS) for leg pain and Oswestry Disability Index (ODI) scores. Then participants were classified into 2 types of migrations (high-grade and low-grade) based on the extent of migration presented on preoperative magnetic resonance imaging (MRI). The various comparisons between the 2 surgical techniques were analyzed.The postoperative VAS and ODI scores significantly decreased in both of the 2 groups after surgery (P < 0.001). The follow-up continued 1 year. With increasing length of follow-up, the disparities in clinical outcomes between the 2 groups were gradually narrowing and there was no significant difference at the end of follow-up (P = 0.32; P = 0.46). There were no differences in the operation time and duration of hospital stay (P = 0.36; P = 0.08). The highly migration group in group B showed a significant longer operation time (P = 0.02), but the extent of migration did not have a significant influence on the operation time in group A with the modified approach (P = 0.19). There were no apparent approach-related complications in group A during the procedure and follow-up period.Foraminoplastic-PELD via upper border of inferior pedicle

  8. Making sense of crowdsourced observations: Data fusion techniques for real-time mapping of urban air quality

    NASA Astrophysics Data System (ADS)

    Schneider, Philipp; Castell, Nuria; Vogt, Matthias; Lahoz, William; Bartonova, Alena

    2015-04-01

    With an ever-increasing amount of environmental observations available through crowdsourcing, one of the major emerging challenges is how to best make sense of the vast amount of collected observations and how to provide citizens and other end-users with a relevant value-added product. Regarding air quality, a high-density network of low-cost sensors provided by crowdsourcing has significant potential for improving spatial mapping in general and in urban areas in particular. However, most datasets of observations made within a crowdsourcing framework contain substantial data gaps and the observations are generally point measurements, which are only representative of a relatively small area. This poses a significant challenge for mapping applications. One way to overcome these issues is to combine the crowdsourced data with spatially continuous data from a model. We present a novel data fusion-based technique for combining real-time crowdsourced observations with model output that allows to provide highly detailed, up-to-date maps of urban air quality. The EU-funded CITI-SENSE project is deploying a dense network of low-cost sensors measuring air quality in eight cities around Europe. These crowdsourced observations are used for mapping urban quality in real-time by fusing them with data obtained from statistical or deterministic air quality models. Data fusion techniques allow for combining observations with model data in a mathematically objective way and therefore provide a means of adding value to both the observations and the model. The observations are improved by filling spatio-temporal gaps in the data and the model is improved by constraining it with observations. The model further provides detailed spatial patterns in areas where no observations are available. As such, data fusion of observations from high-density low-cost sensor networks together with models can contribute to significantly improving urban-scale air quality mapping. The data fusion

  9. Alternative hot spot formation techniques using liquid deuterium-tritium layer inertial confinement fusion capsules

    SciTech Connect

    Olson, R. E.; Leeper, R. J.

    2013-09-15

    The baseline DT ice layer inertial confinement fusion (ICF) ignition capsule design requires a hot spot convergence ratio of ∼34 with a hot spot that is formed from DT mass originally residing in a very thin layer at the inner DT ice surface. In the present paper, we propose alternative ICF capsule designs in which the hot spot is formed mostly or entirely from mass originating within a spherical volume of DT vapor. Simulations of the implosion and hot spot formation in two DT liquid layer ICF capsule concepts—the DT wetted hydrocarbon (CH) foam concept and the “fast formed liquid” (FFL) concept—are described and compared to simulations of standard DT ice layer capsules. 1D simulations are used to compare the drive requirements, the optimal shock timing, the radial dependence of hot spot specific energy gain, and the hot spot convergence ratio in low vapor pressure (DT ice) and high vapor pressure (DT liquid) capsules. 2D simulations are used to compare the relative sensitivities to low-mode x-ray flux asymmetries in the DT ice and DT liquid capsules. It is found that the overall thermonuclear yields predicted for DT liquid layer capsules are less than yields predicted for DT ice layer capsules in simulations using comparable capsule size and absorbed energy. However, the wetted foam and FFL designs allow for flexibility in hot spot convergence ratio through the adjustment of the initial cryogenic capsule temperature and, hence, DT vapor density, with a potentially improved robustness to low-mode x-ray flux asymmetry.

  10. Alternative hot spot formation techniques using liquid deuterium-tritium layer inertial confinement fusion capsules

    NASA Astrophysics Data System (ADS)

    Olson, R. E.; Leeper, R. J.

    2013-09-01

    The baseline DT ice layer inertial confinement fusion (ICF) ignition capsule design requires a hot spot convergence ratio of ˜34 with a hot spot that is formed from DT mass originally residing in a very thin layer at the inner DT ice surface. In the present paper, we propose alternative ICF capsule designs in which the hot spot is formed mostly or entirely from mass originating within a spherical volume of DT vapor. Simulations of the implosion and hot spot formation in two DT liquid layer ICF capsule concepts—the DT wetted hydrocarbon (CH) foam concept and the "fast formed liquid" (FFL) concept—are described and compared to simulations of standard DT ice layer capsules. 1D simulations are used to compare the drive requirements, the optimal shock timing, the radial dependence of hot spot specific energy gain, and the hot spot convergence ratio in low vapor pressure (DT ice) and high vapor pressure (DT liquid) capsules. 2D simulations are used to compare the relative sensitivities to low-mode x-ray flux asymmetries in the DT ice and DT liquid capsules. It is found that the overall thermonuclear yields predicted for DT liquid layer capsules are less than yields predicted for DT ice layer capsules in simulations using comparable capsule size and absorbed energy. However, the wetted foam and FFL designs allow for flexibility in hot spot convergence ratio through the adjustment of the initial cryogenic capsule temperature and, hence, DT vapor density, with a potentially improved robustness to low-mode x-ray flux asymmetry.

  11. Solid Dispersion Matrix Tablet Comprising Indomethacin-PEG-HPMC Fabricated with Fusion and Mold Technique.

    PubMed

    Mesnukul, A; Yodkhum, K; Phaechamud, T

    2009-07-01

    The purpose of this study is to fabricate the polyethylene glycol matrix tablet by mold technique. Indomethacin and hydroxypropylmethylcellulose were used as model drug and polymer, respectively, in PEG matrix system. The physical and drug release characteristics of developed matrix tablet were studied. This inert carrier system comprising 7:3 polyethylene glycol 4000: polyethylene glycol 400 could effectively enhance the solubility of indomethacin and an addition of hydroxypropylmethylcellulose could sustain the drug release. Scanning electron microscope photomicrograph indicated the drug diffusion outward through the porous network of this developed matrix tablet into the dissolution fluid. Least square fitting the experimental dissolution data to the mathematical expressions (power law, first-order, Higuchi's and zero-order) indicated the drug release kinetics primarily as Fickian diffusion. Both the enhancement of drug dissolution and the prolongation of the drug release could be achieved for aqueous insoluble drug such as, indomethacin, by using polyethylene glycol-hydroxypropylmethylcellulose matrix system prepared with melting and mold technique. PMID:20502547

  12. Solid Dispersion Matrix Tablet Comprising Indomethacin-PEG-HPMC Fabricated with Fusion and Mold Technique

    PubMed Central

    Mesnukul, A.; Yodkhum, K.; Phaechamud, T.

    2009-01-01

    The purpose of this study is to fabricate the polyethylene glycol matrix tablet by mold technique. Indomethacin and hydroxypropylmethylcellulose were used as model drug and polymer, respectively, in PEG matrix system. The physical and drug release characteristics of developed matrix tablet were studied. This inert carrier system comprising 7:3 polyethylene glycol 4000: polyethylene glycol 400 could effectively enhance the solubility of indomethacin and an addition of hydroxypropylmethylcellulose could sustain the drug release. Scanning electron microscope photomicrograph indicated the drug diffusion outward through the porous network of this developed matrix tablet into the dissolution fluid. Least square fitting the experimental dissolution data to the mathematical expressions (power law, first-order, Higuchi's and zero-order) indicated the drug release kinetics primarily as Fickian diffusion. Both the enhancement of drug dissolution and the prolongation of the drug release could be achieved for aqueous insoluble drug such as, indomethacin, by using polyethylene glycol-hydroxypropylmethylcellulose matrix system prepared with melting and mold technique. PMID:20502547

  13. A scale space feature based registration technique for fusion of satellite imagery

    NASA Technical Reports Server (NTRS)

    Raghavan, Srini; Cromp, Robert F.; Campbell, William C.

    1997-01-01

    Feature based registration is one of the most reliable methods to register multi-sensor images (both active and passive imagery) since features are often more reliable than intensity or radiometric values. The only situation where a feature based approach will fail is when the scene is completely homogenous or densely textural in which case a combination of feature and intensity based methods may yield better results. In this paper, we present some preliminary results of testing our scale space feature based registration technique, a modified version of feature based method developed earlier for classification of multi-sensor imagery. The proposed approach removes the sensitivity in parameter selection experienced in the earlier version as explained later.

  14. Evaluating the role of large earthquakes on aquifer dynamics using data fusion and knowledge discovery techniques

    NASA Astrophysics Data System (ADS)

    Friedel, Michael; Cox, Simon; Williams, Charles; Holden, Caroline

    2016-04-01

    Artificial adaptive systems are evaluated for their usefulness in modeling earthquake hydrology of the Canterbury region, NZ. For example, an unsupervised machine-learning technique, self-organizing map, is used to fuse about 200 disparate and sparse data variables (such as, well pressure response, ground acceleration, intensity, shaking, stress and strain; aquifer and well characteristics) associated with the M7.1 Darfield earthquake in 2010 and the M6.3 Christchurch earthquake in 2011. The strength of correlations, determined using cross-component plots, varied between earthquakes with pressure changes more strongly related to dynamic- than static stress-related variables during the M7.1 earthquake, and vice versa during the M6.3. The method highlights the importance of data distribution and that driving mechanisms of earthquake-induced pressure change in the aquifers are not straight forward to interpret. In many cases, data mining revealed that confusion and reduction in correlations are associated with multiple trends in the same plot: one for confined and one for unconfined earthquake response. The autocontractive map and minimum spanning tree techniques are used for grouping variables of similar influence on earthquake hydrology. K-means clustering of neural information identified 5 primary regions influenced by the two earthquakes. The application of genetic doping to a genetic algorithm is used for identifying optimal subsets of variables in formulating predictions of well pressures. Predictions of well pressure changes are compared and contrasted using machine-learning network and symbolic regression models with prediction uncertainty quantified using a leave-one-out cross-validation strategy. These preliminary results provide impetus for subsequent analysis with information from another 100 earthquakes that occurred across the South Island.

  15. Estimation of water quality parameters applying satellite data fusion and mining techniques in the lake Albufera de Valencia (Spain)

    NASA Astrophysics Data System (ADS)

    Doña, Carolina; Chang, Ni-Bin; Vannah, Benjamin W.; Sánchez, Juan Manuel; Delegido, Jesús; Camacho, Antonio; Caselles, Vicente

    2014-05-01

    Linked to the enforcement of the European Water Framework Directive (2000) (WFD), which establishes that all countries of the European Union have to avoid deterioration, improve and retrieve the status of the water bodies, and maintain their good ecological status, several remote sensing studies have been carried out to monitor and understand the water quality variables trend. Lake Albufera de Valencia (Spain) is a hypereutrophic system that can present chrorophyll a concentrations over 200 mg·m-3 and transparency (Secchi disk) values below 20 cm, needing to retrieve and improve its water quality. The principal aim of our work was to develop algorithms to estimate water quality parameters such as chlorophyll a concentration and water transparency, which are informative of the eutrophication and ecological status, using remote sensing data. Remote sensing data from Terra/MODIS, Landsat 5-TM and Landsat 7-ETM+ images were used to carry out this study. Landsat images are useful to analyze the spatial variability of the water quality variables, as well as to monitor small to medium size water bodies due to its 30-m spatial resolution. But, the poor temporal resolution of Landsat, with a 16-day revisit time, is an issue. In this work we tried to solve this data gap by applying fusion techniques between Landsat and MODIS images. Although the lower spatial resolution of MODIS is 250/500-m, one image per day is available. Thus, synthetic Landsat images were created using data fusion for no data acquisition dates. Good correlation values were obtained when comparing original and synthetic Landsat images. Genetic programming was used to develop models for predicting water quality. Using the reflectance bands of the synthetic Landsat images as inputs to the model, values of R2 = 0.94 and RMSE = 8 mg·m-3 were obtained when comparing modeled and observed values of chlorophyll a, and values of R2= 0.91 and RMSE = 4 cm for the transparency (Secchi disk). Finally, concentration

  16. An in-situ technique to measure erosion and deposition in fusion devices

    NASA Astrophysics Data System (ADS)

    Ruzic, David N.; Gerdin, Glenn A.

    1987-02-01

    Erosion or deposition of sub-micron layers of graphite or other materials can be measured by bombarding a sub-surface layer of 10B or 6Li with thermal neutrons and observing with a surface-barrier detector the energy loss of the prompt alphas or tritons produced. To demonstrate the feasibility of this technique, a (5250 ± 250) Å layer of boron and a (1.25 ± 0.05) μm layer of Li 2B 4O 7 were electron-beam evaporated onto graphite substrates and exposed to a thermal neutron flux of (8.0 ± 0.5) × 10 5 cm -2 s -1. The (n,α) reactions of the 10B produce a 1.78 MeV α, a 1.48 MeV α, and a 0.848 MeV 7Li. The reactions of 6Li produce a 2.73 MeV 3H and a 2.05 MeV α. Carbon coatings of (600 ± 25) Å, (8250 ± 500) Å, (2.0 ± 0.2) μm, and (4.0 ± 0.4) μm were placed between the active layers and a surface barrier detector in vacuuo. The thinner layers shifted the 1.48 MeV α peak by (31.7 ± 4.5) keV and (431 ± 43) keV respectively. The thicker layers shifted the 2.73 MeV 3H peak by (206 ± 15) keV and (346 ± 20) keV respectfully. Therefore, utilizing boron implants, 100 Å to 1 μm of graphite erosion or redeposition can be determined. Utilizing lithium implants, thicknesses in the range of 1 μm to 10 μm can be determined. Theoretical energy shifts, thermal diffusion, and the feasibility of this technique as a between shot diagnostic for limiters, divertor plates, and/or first-wall armor are discussed.

  17. True anteroposterior view pedicle screw insertion technique

    PubMed Central

    Bai, Jia-yue; Zhang, Wei; An, Ji-long; Sun, Ya-peng; Ding, Wen-yuan; Shen, Yong

    2016-01-01

    Background The wide use of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery in the treatment of degenerative disc disease of lumbar spine in spinal surgery highlights the gradual decrease in the use of traditional pedicle screw insertion technology. This study aims to analyze the accuracy of the true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery, compare it with conventional pedicle screw insertion technology, and discuss its clinical application value. Methods Fifty-two patients undergoing true anteroposterior view (group A) and 87 patients undergoing conventional pedicle screw insertion (group B) were diagnosed with lumbar disc herniation or lumbar spinal stenosis. Time for screw placement, intraoperative irradiation exposure, accuracy rate of pedicle screw insertion, and incidence of neurovascular injury were compared between the two groups. Results The time for screw placement and intraoperative irradiation exposure was significantly less in group A. Penetration rates of the paries lateralis of vertebral pedicle, medial wall of vertebral pedicle, and anterior vertebral wall were 1.44%, 0%, and 2.40%, respectively, all of which were significantly lower than that in group B. No additional serious complications caused by the placement of screw were observed during the follow-up period in patients in group A, but two patients with medial penetration underwent revision for unbearable radicular pain. Conclusion The application of true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery shortens time for screw placement and reduces the intraoperative irradiation exposure along with a higher accuracy rate of screw placement, which makes it a safe, accurate, and efficient technique. PMID:27418828

  18. Wastewater quality monitoring system using sensor fusion and machine learning techniques.

    PubMed

    Qin, Xusong; Gao, Furong; Chen, Guohua

    2012-03-15

    A multi-sensor water quality monitoring system incorporating an UV/Vis spectrometer and a turbidimeter was used to monitor the Chemical Oxygen Demand (COD), Total Suspended Solids (TSS) and Oil & Grease (O&G) concentrations of the effluents from the Chinese restaurant on campus and an electrocoagulation-electroflotation (EC-EF) pilot plant. In order to handle the noise and information unbalance in the fused UV/Vis spectra and turbidity measurements during the calibration model building, an improved boosting method, Boosting-Iterative Predictor Weighting-Partial Least Squares (Boosting-IPW-PLS), was developed in the present study. The Boosting-IPW-PLS method incorporates IPW into boosting scheme to suppress the quality-irrelevant variables by assigning small weights, and builds up the models for the wastewater quality predictions based on the weighted variables. The monitoring system was tested in the field with satisfactory results, underlying the potential of this technique for the online monitoring of water quality. PMID:22200261

  19. Comparison of the resulting error in data fusion techniques when used with remote sensing, earth observation, and in-situ data sets for water quality applications

    NASA Astrophysics Data System (ADS)

    Ziemba, Alexander; El Serafy, Ghada

    2016-04-01

    Ecological modeling and water quality investigations are complex processes which can require a high level of parameterization and a multitude of varying data sets in order to properly execute the model in question. Since models are generally complex, their calibration and validation can benefit from the application of data and information fusion techniques. The data applied to ecological models comes from a wide range of sources such as remote sensing, earth observation, and in-situ measurements, resulting in a high variability in the temporal and spatial resolution of the various data sets available to water quality investigators. It is proposed that effective fusion into a comprehensive singular set will provide a more complete and robust data resource with which models can be calibrated, validated, and driven by. Each individual product contains a unique valuation of error resulting from the method of measurement and application of pre-processing techniques. The uncertainty and error is further compounded when the data being fused is of varying temporal and spatial resolution. In order to have a reliable fusion based model and data set, the uncertainty of the results and confidence interval of the data being reported must be effectively communicated to those who would utilize the data product or model outputs in a decision making process[2]. Here we review an array of data fusion techniques applied to various remote sensing, earth observation, and in-situ data sets whose domains' are varied in spatial and temporal resolution. The data sets examined are combined in a manner so that the various classifications, complementary, redundant, and cooperative, of data are all assessed to determine classification's impact on the propagation and compounding of error. In order to assess the error of the fused data products, a comparison is conducted with data sets containing a known confidence interval and quality rating. We conclude with a quantification of the performance

  20. Development of design technique for vacuum insulation in large size multi-aperture multi-grid accelerator for nuclear fusion.

    PubMed

    Kojima, A; Hanada, M; Tobari, H; Nishikiori, R; Hiratsuka, J; Kashiwagi, M; Umeda, N; Yoshida, M; Ichikawa, M; Watanabe, K; Yamano, Y; Grisham, L R

    2016-02-01

    Design techniques for the vacuum insulation have been developed in order to realize a reliable voltage holding capability of multi-aperture multi-grid (MAMuG) accelerators for fusion application. In this method, the nested multi-stage configuration of the MAMuG accelerator can be uniquely designed to satisfy the target voltage within given boundary conditions. The evaluation of the voltage holding capabilities of each acceleration stages was based on the previous experimental results about the area effect and the multi-aperture effect. Since the multi-grid effect was found to be the extension of the area effect by the total facing area this time, the total voltage holding capability of the multi-stage can be estimated from that per single stage by assuming the stage with the highest electric field, the total facing area, and the total apertures. By applying these consideration, the analysis on the 3-stage MAMuG accelerator for JT-60SA agreed well with the past gap-scan experiments with an accuracy of less than 10% variation, which demonstrated the high reliability to design MAMuG accelerators and also multi-stage high voltage bushings. PMID:26932032

  1. Measurement of Hydrodynamic Growth near Peak Velocity in an Inertial Confinement Fusion Capsule Implosion using a Self-Radiography Technique.

    PubMed

    Pickworth, L A; Hammel, B A; Smalyuk, V A; MacPhee, A G; Scott, H A; Robey, H F; Landen, O L; Barrios, M A; Regan, S P; Schneider, M B; Hoppe, M; Kohut, T; Holunga, D; Walters, C; Haid, B; Dayton, M

    2016-07-15

    First measurements of hydrodynamic growth near peak implosion velocity in an inertial confinement fusion (ICF) implosion at the National Ignition Facility were obtained using a self-radiographing technique and a preimposed Legendre mode 40, λ=140  μm, sinusoidal perturbation. These are the first measurements of the total growth at the most unstable mode from acceleration Rayleigh-Taylor achieved in any ICF experiment to date, showing growth of the areal density perturbation of ∼7000×. Measurements were made at convergences of ∼5 to ∼10× at both the waist and pole of the capsule, demonstrating simultaneous measurements of the growth factors from both lines of sight. The areal density growth factors are an order of magnitude larger than prior experimental measurements and differed by ∼2× between the waist and the pole, showing asymmetry in the measured growth factors. These new measurements significantly advance our ability to diagnose perturbations detrimental to ICF implosions, uniquely intersecting the change from an accelerating to decelerating shell, with multiple simultaneous angular views. PMID:27472117

  2. Measurement of Hydrodynamic Growth near Peak Velocity in an Inertial Confinement Fusion Capsule Implosion using a Self-Radiography Technique

    NASA Astrophysics Data System (ADS)

    Pickworth, L. A.; Hammel, B. A.; Smalyuk, V. A.; MacPhee, A. G.; Scott, H. A.; Robey, H. F.; Landen, O. L.; Barrios, M. A.; Regan, S. P.; Schneider, M. B.; Hoppe, M.; Kohut, T.; Holunga, D.; Walters, C.; Haid, B.; Dayton, M.

    2016-07-01

    First measurements of hydrodynamic growth near peak implosion velocity in an inertial confinement fusion (ICF) implosion at the National Ignition Facility were obtained using a self-radiographing technique and a preimposed Legendre mode 40, λ =140 μ m , sinusoidal perturbation. These are the first measurements of the total growth at the most unstable mode from acceleration Rayleigh-Taylor achieved in any ICF experiment to date, showing growth of the areal density perturbation of ˜7000 × . Measurements were made at convergences of ˜5 to ˜10 × at both the waist and pole of the capsule, demonstrating simultaneous measurements of the growth factors from both lines of sight. The areal density growth factors are an order of magnitude larger than prior experimental measurements and differed by ˜2 × between the waist and the pole, showing asymmetry in the measured growth factors. These new measurements significantly advance our ability to diagnose perturbations detrimental to ICF implosions, uniquely intersecting the change from an accelerating to decelerating shell, with multiple simultaneous angular views.

  3. Measurement of hydrodynamic growth near peak velocity in an inertial confinement fusion capsule implosion using a self-radiography technique

    DOE PAGESBeta

    Pickworth, L. A.; Hammel, B. A.; Smalyuk, V. A.; MacPhee, A. G.; Scott, H. A.; Robey, H. F.; Landen, O. L.; Barrios, M. A.; Regan, S. P.; Schneider, M. B.; et al

    2016-07-11

    First measurements of hydrodynamic growth near peak implosion velocity in an inertial confinement fusion (ICF) implosion at the National Ignition Facility were obtained using a self-radiographing technique and a preimposed Legendre mode 40, λ = 140 μm, sinusoidal perturbation. These are the first measurements of the total growth at the most unstable mode from acceleration Rayleigh-Taylor achieved in any ICF experiment to date, showing growth of the areal density perturbation of ~7000×. Measurements were made at convergences of ~5 to ~10× at both the waist and pole of the capsule, demonstrating simultaneous measurements of the growth factors from both linesmore » of sight. The areal density growth factors are an order of magnitude larger than prior experimental measurements and differed by ~2× between the waist and the pole, showing asymmetry in the measured growth factors. As a result, these new measurements significantly advance our ability to diagnose perturbations detrimental to ICF implosions, uniquely intersecting the change from an accelerating to decelerating shell, with multiple simultaneous angular views.« less

  4. Multi-energy soft-x-ray technique for impurity transport measurements in the fusion plasma edge

    NASA Astrophysics Data System (ADS)

    Clayton, D. J.; Tritz, K.; Stutman, D.; Finkenthal, M.; Kaye, S. M.; Kumar, D.; LeBlanc, B. P.; Paul, S.; Sabbagh, S. A.

    2012-10-01

    A new diagnostic technique was developed to produce high-resolution impurity transport measurements of the steep-gradient edge of fusion plasmas. Perturbative impurity transport measurements were performed for the first time in the NSTX plasma edge (r/a ˜ 0.6 to the SOL) with short neon gas puffs, and the resulting line and continuum emission was measured with the new edge multi-energy soft-x-ray (ME-SXR) diagnostic. Neon transport is modeled with the radial impurity transport code STRAHL and the resulting x-ray emission is computed using the ADAS atomic database. The radial transport coefficient profiles D(r) and v(r), and the particle flux from the gas puff Φ(t), are the free parameters in this model and are varied to find the best fit to experimental x-ray emissivity measurements, with bolometry used to constrain the impurity source. Initial experiments were successful and results were consistent with previous measurements of core impurity transport and neoclassical transport calculations. New diagnostic tools will be implemented on NSTX-U to further improve these transport measurements.

  5. Development of design technique for vacuum insulation in large size multi-aperture multi-grid accelerator for nuclear fusion

    NASA Astrophysics Data System (ADS)

    Kojima, A.; Hanada, M.; Tobari, H.; Nishikiori, R.; Hiratsuka, J.; Kashiwagi, M.; Umeda, N.; Yoshida, M.; Ichikawa, M.; Watanabe, K.; Yamano, Y.; Grisham, L. R.

    2016-02-01

    Design techniques for the vacuum insulation have been developed in order to realize a reliable voltage holding capability of multi-aperture multi-grid (MAMuG) accelerators for fusion application. In this method, the nested multi-stage configuration of the MAMuG accelerator can be uniquely designed to satisfy the target voltage within given boundary conditions. The evaluation of the voltage holding capabilities of each acceleration stages was based on the previous experimental results about the area effect and the multi-aperture effect. Since the multi-grid effect was found to be the extension of the area effect by the total facing area this time, the total voltage holding capability of the multi-stage can be estimated from that per single stage by assuming the stage with the highest electric field, the total facing area, and the total apertures. By applying these consideration, the analysis on the 3-stage MAMuG accelerator for JT-60SA agreed well with the past gap-scan experiments with an accuracy of less than 10% variation, which demonstrated the high reliability to design MAMuG accelerators and also multi-stage high voltage bushings.

  6. Development and Application of Non-Linear Image Enhancement and Multi-Sensor Fusion Techniques for Hazy and Dark Imaging

    NASA Technical Reports Server (NTRS)

    Rahman, Zia-ur

    2005-01-01

    The purpose of this research was to develop enhancement and multi-sensor fusion algorithms and techniques to make it safer for the pilot to fly in what would normally be considered Instrument Flight Rules (IFR) conditions, where pilot visibility is severely restricted due to fog, haze or other weather phenomenon. We proposed to use the non-linear Multiscale Retinex (MSR) as the basic driver for developing an integrated enhancement and fusion engine. When we started this research, the MSR was being applied primarily to grayscale imagery such as medical images, or to three-band color imagery, such as that produced in consumer photography: it was not, however, being applied to other imagery such as that produced by infrared image sources. However, we felt that it was possible by using the MSR algorithm in conjunction with multiple imaging modalities such as long-wave infrared (LWIR), short-wave infrared (SWIR), and visible spectrum (VIS), we could substantially improve over the then state-of-the-art enhancement algorithms, especially in poor visibility conditions. We proposed the following tasks: 1) Investigate the effects of applying the MSR to LWIR and SWIR images. This consisted of optimizing the algorithm in terms of surround scales, and weights for these spectral bands; 2) Fusing the LWIR and SWIR images with the VIS images using the MSR framework to determine the best possible representation of the desired features; 3) Evaluating different mixes of LWIR, SWIR and VIS bands for maximum fog and haze reduction, and low light level compensation; 4) Modifying the existing algorithms to work with video sequences. Over the course of the 3 year research period, we were able to accomplish these tasks and report on them at various internal presentations at NASA Langley Research Center, and in presentations and publications elsewhere. A description of the work performed under the tasks is provided in Section 2. The complete list of relevant publications during the research

  7. Spinal fusion

    MedlinePlus

    ... Anterior spinal fusion; Spine surgery - spinal fusion; Low back pain - fusion; Herniated disk - fusion ... If you had chronic back pain before surgery, you will likely still have some pain afterward. Spinal fusion is unlikely to take away all your pain ...

  8. Older literature review of increased risk of adjacent segment degeneration with instrumented lumbar fusions

    PubMed Central

    Epstein, Nancy E.

    2016-01-01

    Background: Adjacent segment degeneration (ASD) following lumbar spine surgery occurs in up to 30% of cases, and descriptions of such changes are not new. Here, we review some of the older literature concerning the rate of ASD, typically more severe cephalad than caudad, and highly correlated with instrumented fusions. Therefore, for degenerative lumbar disease without frank instability, ASD would be markedly reduced by avoiding instrumented fusions. Methods: In a prior review, the newer literature regarding the frequency of ASD following lumbar instrumented fusions (e.g., transforaminal or posterior lumbar interbody fusions [TLIF/PLIF] fusions or occasionally, posterolateral fusions [PLFs]) was presented. Some studies cited an up to an 18.5% incidence of ASD following instrumented versus noninstrumented fusions/decompressions alone (5.6%). A review of the older literature similarly documents a higher rate of ASD following instrumented fusions performed for degenerative lumbar disease alone. Results: More frequent and more severe ASD follows instrumented lumbar fusions performed for degenerative lumbar disease without instability. Alternatively, this entity should be treated with decompressions alone or with noninstrumented fusions, without the addition of instrumentation. Conclusions: Too many studies assume that TLIF, PLIF, and even PLF instrumented fusions are the “gold standard of care” for dealing with degenerative disease of the lumbar spine without documented instability. It is time to correct that assumption, and reassess the older literature along with the new to confirm that decompression alone and noninstrumented fusion avoid significant morbidity and even potentially mortality attributed to unnecessary instrumentation. PMID:26904370

  9. Final Report on Development of Optimized Field-Reversed Configuration Plasma Formation Techniques for Magnetized Target Fusion

    SciTech Connect

    Lynn, Alan

    2013-11-01

    The University of New Mexico (UNM) proposed a collaboration with Los Alamos National Laboratory (LANL) to develop and test methods for improved formation of field-reversed configuration (FRC) plasmas relevant to magnetized target fusion (MTF) energy research. MTF is an innovative approach for a relatively fast and cheap path to the production of fusion energy that utilizes magnetic confinement to assist in the compression of a hot plasma to thermonuclear conditions by an external driver. LANL is currently pursing demonstration of the MTF concept via compression of an FRC plasma by a metal liner z-pinch in conjunction with the Air Force Research Laboratory in Albuquerque, NM. A key physics issue for the FRC's ultimate success as an MTF target lies in the initial pre-ionization (PI) stage. The PI plasma sets the initial conditions from which the FRC is created. In particular, the PI formation process determines the amount of magnetic flux that can be trapped to form the FRC. A ringing theta pinch ionization (RTPI) technique, such as currently used by the FRX-L device at LANL, has the advantages of high ionization fraction, simplicity (since no additional coils are required), and does not require internal electrodes which can introduce impurities into the plasma. However RTPI has been shown to only trap 50% of the initial bias flux at best and imposes additional engineering constraints on the capacitor banks. The amount of trapped flux plays an important role in the FRC's final equilibrium, transport, and stability properties, and provides increased ohmic heating of the FRC through induced currents as the magnetic field decays. Increasing the trapped flux also provides the route to greatest potential gains in FRC lifetime, which is essential to provide enough time to translate and compress the FRC effectively. In conjunction with LANL we initially planned to develop and test a microwave break- down system to improve the initial PI plasma formation. The UNM team would

  10. A simple, rapid, low-cost technique for naked-eye detection of urine-isolated TMPRSS2:ERG gene fusion RNA.

    PubMed

    Koo, Kevin M; Wee, Eugene J H; Mainwaring, Paul N; Trau, Matt

    2016-01-01

    The TMPRSS2:ERG gene fusion is one of a series of highly promising prostate cancer (PCa) biomarker alternatives to the controversial serum PSA. Current methods for detecting TMPRSS2:ERG are limited in terms of long processing time, high cost and the need for specialized equipment. Thus, there is an unmet need for less complex, faster, and cheaper methods to enable gene fusion detection in the clinic. We describe herein a simple, rapid and inexpensive assay which combines robust isothermal amplification technique with a novel visualization method for evaluating urinary TMPRSS2:ERG status at less than USD 5 and with minimal equipment. The assay is sensitive, and rapidly detects as low as 10(5) copies of TMPRSS2:ERG transcripts while maintaining high levels of specificity. PMID:27470540

  11. A simple, rapid, low-cost technique for naked-eye detection of urine-isolated TMPRSS2:ERG gene fusion RNA

    PubMed Central

    Koo, Kevin M.; Wee, Eugene J. H.; Mainwaring, Paul N.; Trau, Matt

    2016-01-01

    The TMPRSS2:ERG gene fusion is one of a series of highly promising prostate cancer (PCa) biomarker alternatives to the controversial serum PSA. Current methods for detecting TMPRSS2:ERG are limited in terms of long processing time, high cost and the need for specialized equipment. Thus, there is an unmet need for less complex, faster, and cheaper methods to enable gene fusion detection in the clinic. We describe herein a simple, rapid and inexpensive assay which combines robust isothermal amplification technique with a novel visualization method for evaluating urinary TMPRSS2:ERG status at less than USD 5 and with minimal equipment. The assay is sensitive, and rapidly detects as low as 105 copies of TMPRSS2:ERG transcripts while maintaining high levels of specificity. PMID:27470540

  12. A new microcolumn-type microchip for examining the expression of chimeric fusion genes using a nucleic acid sandwich hybridization technique.

    PubMed

    Ohnishi, Michihiro; Sasaki, Naoyuki; Kishimoto, Takuya; Watanabe, Hidetoshi; Takagi, Masatoshi; Mizutani, Shuki; Kishii, Noriyuki; Yasuda, Akio

    2014-11-01

    We report a new type of microcolumn installed in a microchip. The architecture allows use of a nucleic acid sandwich hybridization technique to detect a messenger RNA (mRNA) chain as a target. Data are presented that demonstrate that the expression of a chimeric fusion gene can be detected. The microcolumn was filled with semi-transparent microbeads made of agarose gel that acted as carriers, allowing increased efficiency of the optical detection of fluorescence from the microcolumn. The hybrid between the target trapped on the microbeads and a probe DNA labeled with a fluorescent dye was detected by measuring the intensity of the fluorescence from the microcolumn directly. These results demonstrate an easy and simple method for determining the expression of chimeric fusion genes with no preamplification. PMID:25240923

  13. Application of principal component analysis and information fusion technique to detect hotspots in NOAA/AVHRR images of Jharia coalfield, India - article no. 013523

    SciTech Connect

    Gautam, R.S.; Singh, D.; Mittal, A.

    2007-07-01

    Present paper proposes an algorithm for hotspot (sub-surface fire) detection in NOAA/AVHRR images in Jharia region of India by employing Principal Component Analysis (PCA) and fusion technique. Proposed technique is very simple to implement and is more adaptive in comparison to thresholding, multi-thresholding and contextual algorithms. The algorithm takes into account the information of AVHRR channels 1, 2, 3, 4 and vegetation indices NDVI and MSAVI for the required purpose. Proposed technique consists of three steps: (1) detection and removal of cloud and water pixels from preprocessed AVHRR image and screening out the noise of channel 3, (2) application of PCA on multi-channel information along with vegetation index information of NOAA/AVHRR image to obtain principal components, and (3) fusion of information obtained from principal component 1 and 2 to classify image pixels as hotspots. Image processing techniques are applied to fuse information in first two principal component images and no absolute threshold is incorporated to specify whether particular pixel belongs to hotspot class or not, hence, proposed method is adaptive in nature and works successfully for most of the AVHRR images with average 87.27% detection accuracy and 0.201% false alarm rate while comparing with ground truth points in Jharia region of India.

  14. Multisensor data fusion algorithm development

    SciTech Connect

    Yocky, D.A.; Chadwick, M.D.; Goudy, S.P.; Johnson, D.K.

    1995-12-01

    This report presents a two-year LDRD research effort into multisensor data fusion. We approached the problem by addressing the available types of data, preprocessing that data, and developing fusion algorithms using that data. The report reflects these three distinct areas. First, the possible data sets for fusion are identified. Second, automated registration techniques for imagery data are analyzed. Third, two fusion techniques are presented. The first fusion algorithm is based on the two-dimensional discrete wavelet transform. Using test images, the wavelet algorithm is compared against intensity modulation and intensity-hue-saturation image fusion algorithms that are available in commercial software. The wavelet approach outperforms the other two fusion techniques by preserving spectral/spatial information more precisely. The wavelet fusion algorithm was also applied to Landsat Thematic Mapper and SPOT panchromatic imagery data. The second algorithm is based on a linear-regression technique. We analyzed the technique using the same Landsat and SPOT data.

  15. Single-level cervical radiculopathy: clinical outcome and cost-effectiveness of four techniques of anterior cervical discectomy and fusion and disc arthroplasty.

    PubMed

    Bhadra, Arup K; Raman, A S; Casey, Adrian T H; Crawford, R J

    2009-02-01

    Although there are several accepted methods of surgical treatment for single-level cervical radiculopathy, the choice depend on the surgeon's preference. The techniques may vary in peri-operative morbidity, short- and long-term outcome, but no study so far has analyzed their cost-effectiveness. This study might give some insight in balancing cost and effectiveness and deciding the right technique. Sixty consecutive patients (15 each group), mean age 36 (range 24-76 years) with single-level cervical disc disease underwent surgical treatment with four different techniques in two centers over the period of 1999-2005. The four groups were--(1) plate and tricortical autograft, (2) plate, cage, and bone substitute, (3) cage only, and (4) disc arthroplasty. The data was collected prospectively according to our protocol and subsequently analyzed. The clinical outcome was assessed comparing visual analog scale (VAS) of neck pain and, short form 12 (SF12) questionnaire both pre- and postoperatively. The radiological assessment was done for fusion rate and postoperative related possible complications at 3 months, 6 months, 1 year, and final follow-up. The cost analysis was done calculating the operative time, hospital stay, implant cost together. The mean follow-up period was 31 months (range 28-43 months). The clinical outcome in terms of VAS of neck and arm pain and SF12 physical and mental score improvement (P=0.001) were comparable with all four techniques. The radiological fusion rate was comparable to current available data. As the hospital stay was longer (average 5 days) with plate and autograft group, the total cost was maximum (average 2,920 pound sterling) with this group. There was satisfactory clinical and radiological outcome with all four techniques. Using the cage alone was the most cost-effective technique, but the disc arthroplasty was comparable to the use of cage and plate. Anterior cervical discectomy and fusion is an established surgical treatment for

  16. Determination of tungsten in tantalum-tungsten alloy by X-ray fluorescence spectrometry using fusion, thin layer, and pressed powder pellet techniques

    NASA Astrophysics Data System (ADS)

    Tian, Lunfu; Zou, Deshuang; Dai, Yichun; Tang, Guangping

    2015-08-01

    A method is described for the X-ray fluorescence (XRF) determination of tungsten in tantalum-tungsten alloy over the range of 10.5%-13.5%. The sample was prepared by three methods, namely, borate fusion, filter paper disk, and pressed powder pellet, respectively. We compared the feature of the three methods of specimen preparation and found that filter paper disk method was the most suitable technique for specimen preparation. Furthermore, the results were compared with those given by inductively coupled plasma optical emission spectrometry (ICP-OES), and the relative standard deviation was less than 2%, which could meet the requirement of this application.

  17. The Effectiveness of Transforaminal Versus Caudal Routes for Epidural Steroid Injections in Managing Lumbosacral Radicular Pain

    PubMed Central

    Liu, Jun; Zhou, Hengxing; Lu, Lu; Li, Xueying; Jia, Jun; Shi, Zhongju; Yao, Xue; Wu, Qiuli; Feng, Shiqing

    2016-01-01

    Abstract Epidural steroid injection (ESI) is one of the most commonly used treatments for radiculopathy. Previous studies have described the effectiveness of ESI in the management of radiculopathy. However, controversy exists regarding the route that is most beneficial and effective with respect to the administration of epidural steroids, as both transforaminal (TF) and caudal (C) routes are commonly used. This analysis reviewed studies comparing the effectiveness of TF-ESIs with that of C-ESIs in the treatment of radiculopathy as a means of providing pain relief and improving functionality. This meta-analysis was performed to guide clinical decision-making. The study was a systematic review of comparative studies. A systematic literature search was performed using the PubMed, EMBASE, and Cochrane Library databases for trials written in English. The randomized trials and observational studies that met our inclusion criteria were subsequently included. Two reviewers, respectively, extracted data and estimated the risk of bias. All statistical analyses were performed using Review Manager 5.3. Six prospective and 2 retrospective studies involving 664 patients were included. Statistical analysis was performed utilizing only the 6 prospective studies. Although slight pain and functional improvements were noted in the TF-ESI groups compared with the C-ESI groups, these improvements were neither clinically nor statistically significant. The limitations of this meta-analysis resulted primarily from the weaknesses of the comparative studies and the relative paucity of patients included in each study. Both the TF and C approaches are effective in reducing pain and improving functional scores, and they demonstrated similar efficacies in the management of lumbosacral radicular pain. PMID:27149443

  18. Comparison of Transforaminal and Parasagittal Epidural Steroid Injections in Patients With Radicular Low Back Pain

    PubMed Central

    Hashemi, Seyed Masoud; Aryani, Mohamad Reza; Momenzadeh, Sirus; Razavi, Seyed Sajad; Mohseni, Gholamreza; Mohajerani, Seyed Amir; Esmilijah, Ali Akbar

    2015-01-01

    Background: Epidural steroid injection (ESI), including transforaminal (TF) epidural injections and interlaminar (IL) epidural steroid injections are commonly performed procedures for the management of lumbosacral radicular pain. Parasagittal interlaminar (PIL) approach could enable higher ventral epidural spread, with fewer complications than TF. Objectives: This study aims to compare the effectiveness of PIL and TF ESI in relieving the pain and disability of patients with lumbosacral pain. Patients and Methods: This prospective study enrolled 64 patients, aged between 18 to 75 years, with a diagnosis of low back pain and unilateral lumbosacral radicular pain. The patients were randomized to receive fluoroscopically guided epidural injection, through either the PIL or TF approach. Patients were evaluated for effective pain relief [numerical rating scale (NRS) < 3] by 0 - 10 numeric rating scale (NRS) and functional improvement by the Oswestry Disability Index (ODI). Results: Effective pain relief [numeric rating scale (NRS) < 3] was observed in 77.3% (95% CI: 67‒90.5%) of patients in PIL group and 74.2% (95% CI: 62.4 - 89.4%) of patients in the TF group (P = 0.34), at 4 weeks. Mean NRS score was not significantly different between the PIL group compared to the TF group, at 4 weeks (P = 0.19). Number of patients with improved disability (measured by ODI < 20%) was not significantly different in PIL group (78% of cases) compared to the TF group (76% of cases), at 4 weeks (P = 0.21). There were no adverse effects observed in any of our patients. Conclusions: The PIL epidural injection is as effective as TF epidural injection in improving pain and functional status, in patients with chronic lumbosacral low back pain, due to disc degeneration. PMID:26587400

  19. Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis: The Insertion Technique, the Fusion Levels and Direct Vertebral Rotation

    PubMed Central

    2011-01-01

    The pedicle is a power nucleus of the vertebra and offers a secure grip of all 3 columns. Pedicle screw instrumentation has advantages of rigid fixation with improved three-dimensional (3D) correction and it is accepted as a reliable method with a high margin of safety. Accurate placement of the pedicle screws is important to reduce possible irreversible complications. Many methods of screw insertion have been reported. The author has been using the K-wire method coupled with the intraoperative single posteroanterior and lateral radiographs, which is the most safe, accurate and fast method. Identification of the curve patterns and determining the fusion levels are very important. The ideal classification of adolescent idiopathic scoliosis should address the all patterns, predict the extent of accurate fusion and have good inter/intraobserver reliability. My classification system matches with the ideal classification system, and it is simple and easy to learn; and my classification system has only 4 structural curve patterns and each curve has 2 types. Scoliosis is a 3D deformity; the coronal and sagittal curves can be corrected with rod rotation, and rotational deformity has to be corrected with direct vertebral rotation (DVR). Rod derotation and DVR are true methods of 3D deformity correction with shorter fusion and improved correction of both the fused and unfused curves, and this is accomplished using pedicle screw fixation. The direction of DVR is very important and it should be opposite to the direction of the rotational deformity of the vertebra. A rigid rod has to be used to prevent rod bend-out during the derotation and DVR. PMID:21629468

  20. Flow Cytometric Immunobead Assay for Detection of BCR-ABL1 Fusion Proteins in Chronic Myleoid Leukemia: Comparison with FISH and PCR Techniques

    PubMed Central

    Recchia, Anna Grazia; Caruso, Nadia; Bossio, Sabrina; Pellicanò, Mariavaleria; De Stefano, Laura; Franzese, Stefania; Palummo, Angela; Abbadessa, Vincenzo; Lucia, Eugenio; Gentile, Massimo; Vigna, Ernesto; Caracciolo, Clementina; Agostino, Antolino; Galimberti, Sara; Levato, Luciano; Stagno, Fabio; Molica, Stefano; Martino, Bruno; Vigneri, Paolo; Di Raimondo, Francesco; Morabito, Fortunato

    2015-01-01

    Chronic Myeloid Leukemia (CML) is characterized by a balanced translocation juxtaposing the Abelson (ABL) and breakpoint cluster region (BCR) genes. The resulting BCR-ABL1 oncogene leads to increased proliferation and survival of leukemic cells. Successful treatment of CML has been accompanied by steady improvements in our capacity to accurately and sensitively monitor therapy response. Currently, measurement of BCR-ABL1 mRNA transcript levels by real-time quantitative PCR (RQ-PCR) defines critical response endpoints. An antibody-based technique for BCR-ABL1 protein recognition could be an attractive alternative to RQ-PCR. To date, there have been no studies evaluating whether flow-cytometry based assays could be of clinical utility in evaluating residual disease in CML patients. Here we describe a flow-cytometry assay that detects the presence of BCR-ABL1 fusion proteins in CML lysates to determine the applicability, reliability, and specificity of this method for both diagnosis and monitoring of CML patients for initial response to therapy. We show that: i) CML can be properly diagnosed at onset, (ii) follow-up assessments show detectable fusion protein (i.e. relative mean fluorescent intensity, rMFI%>1) when BCR-ABL1IS transcripts are between 1–10%, and (iii) rMFI% levels predict CCyR as defined by FISH analysis. Overall, the FCBA assay is a rapid technique, fully translatable to the routine management of CML patients. PMID:26111048

  1. Toughness characterization by small specimen test technique for HIPed joints of F82H steel aiming at first wall fabrication in fusion

    NASA Astrophysics Data System (ADS)

    Kishimoto, H.; Ono, T.; Sakasegawa, H.; Tanigawa, H.; Kohno, Y.; Kohyama, A.

    2013-09-01

    Reduced activation ferritic/martensitic steels (RAFMs), such as F82H steels, have been developed as candidates of structural materials for fusion. In the design of a fusion reactor, cooling channels are built in the first wall of the blanket. One large issue is to determine how to join rectangular tubes to thin panels to fabricate the first wall. Hot Isostatic Pressing (HIPing) is a solution to solve the issue. Because of the thin HIPed walls of the channels, the specimen size for inspection of HIPed interface is limited. In the present research, Small Specimen Test Techniques (SSTT) are screened for the destructive toughness investigation technique of HIPed F82H joints. 1/3 size Charpy V-notch impact (1/3 CVN) and small punch (SP) tests are employed for the present research. The toughness of the HIPed joints is strongly affected by various surface finishing of specimens treated previous to the HIPing. In the present research, several kinds of HIPed joints were surface finished by different methods and investigated by 1/3 CVN impact test. The HIPed F82H joints had different toughness ranging from 20% to 70% of the toughness of the F82H base metal. The SP test is also available for the investigation of toughness change by the HIPing. The sensitivity of 1/3 CVN impact test against toughness change was better than the SP test, it revealed that the SP test has some limitations.

  2. Transforaminal Endoscopic Lumbar Decompression & Foraminoplasty: A 10 Year prospective survivability outcome study of the treatment of foraminal stenosis and failed back surgery

    PubMed Central

    Knight, Martin TN; Jago, Ingrid; Norris, Christopher; Midwinter, Lynne; Boynes, Christopher

    2014-01-01

    Background Conventional diagnosis between axial and foraminal stenosis is suboptimal and long-term outcomes limited to posterior decompression. Aware state Transforaminal Endoscopic Lumbar Decompression and Foraminoplasty (TELDF) offers a direct aware state means of localizing and treating neuro-claudicant back pain, referred pain and weakness associated with stenosis failing to respond to conventional rehabilitation, pain management or surgery. This prospective survivability study examines the outcomes 10 years after TELDF in patients with foraminal stenosis arising from degeneration or failed back surgery. Methods For 10 years prospective data were collected on 114 consecutive patients with multilevel spondylosis and neuro-claudicant back pain, referred pain and weakness with or without failed back surgery whose symptoms had failed to respond to conventional rehabilitation and pain management and who underwent TELDF. The level responsible for the predominant presenting symptoms of foraminal stenosis, determined on clinical grounds, MRI and or CT scans, was confirmed by transforaminal probing and discography. Patients underwent TELDF at the spinal segment at which the predominant presenting symptoms were reproduced. Those that required treatment at an additional segment were excluded. Outcomes were assessed by postal questionnaire with failures being examined by the independent authors using the Visual Analogue Pain Scale (VAPS), the Oswestry Disability Index (ODI) and the Prolo Activity Score. Results Cohort integrity was 69%. 79 patients were available for evaluation after removal of the deceased (12), untraceable (17) and decliners (6) from the cohort. VAP scores improved from a pre-operative mean of 7.3 to 2.4 at year 10. The ODI improved from a mean of 58.5 at baseline to 17.5 at year 10. 72% of reviewed patients fulfilled the definition of an “Excellent” or “Good Clinical Impact” at review using the Spinal Foundation Outcome Score. Based on the Prolo

  3. Evaluation of Transforaminal Endoscopic Discectomy in Treatment of Obese Patients with Lumbar Disc Herniation.

    PubMed

    Wang, Ya-Peng; Zhang, Wei; An, Ji-Long; Zhang, Jian; Bai, Jia-Yue; Sun, Ya-Peng

    2016-01-01

    BACKGROUND This study aimed to evaluate the efficacy of transforaminal endoscopic discectomy (TED) in the treatment of obese patients with lumbar disc herniation (LDH). MATERIAL AND METHODS A total of 69 obese patients with LDH (35 males and 34 females; age range, 24 to 43 years; median age, 34 years) were included in this study. These patients had undergone TED from March 2011 to December 2015 in the Third Hospital of Hebei Medical University. Their clinical and follow-up data were prospectively analyzed. The degree of pain and disability were measured on the basis of the Visual Analog Scale (VAS) at 1 day before surgery, immediately after surgery, and 3 months after surgery. Neurologic functions were measured on the basis of the Japanese Orthopaedic Association (JOA) system 1 day before surgery and 3 months after surgery. The MacNab score at last follow-up was recorded to evaluate the early clinical efficacy. Complications during and after the operation were recorded to evaluate the safety of surgery. RESULTS Two patients experienced abnormal sensations in the export nerve root zone postoperatively, which disappeared after 3 days of treatment with dehydration and administration of hormone (dexamethasone). Three cases of recurrence were observed at 6 months, 7 months, and 9 months postoperatively; they were scheduled to receive total laminectomy combined with bone grafting internal fixation. A total of 67 patients were followed up for 3-23 months and mean follow-up was 11.8 months. The VAS scores at postoperative 3 months and 1 year were significantly reduced compared to that before the operation, with significant differences between them (t=43.072, P<0.05; t=43.139, P<0.05). The JOA scores at last follow-up postoperatively was significantly higher than that before surgery (t=-60.312, P<0.05). At the last follow-up, 17 cases (25.3%) had excellent outcomes, 39 (58.2%) good, 7 (10.4%) fair, and 4 (5.9%) poor. Overall, 83.5% of patients had excellent or good rates

  4. Evaluation of Transforaminal Endoscopic Discectomy in Treatment of Obese Patients with Lumbar Disc Herniation

    PubMed Central

    Wang, Ya-peng; Zhang, Wei; An, Ji-long; Zhang, Jian; Bai, Jia-yue; Sun, Ya-peng

    2016-01-01

    Background This study aimed to evaluate the efficacy of transforaminal endoscopic discectomy (TED) in the treatment of obese patients with lumbar disc herniation (LDH). Material/Methods A total of 69 obese patients with LDH (35 males and 34 females; age range, 24 to 43 years; median age, 34 years) were included in this study. These patients had undergone TED from March 2011 to December 2015 in the Third Hospital of Hebei Medical University. Their clinical and follow-up data were prospectively analyzed. The degree of pain and disability were measured on the basis of the Visual Analog Scale (VAS) at 1 day before surgery, immediately after surgery, and 3 months after surgery. Neurologic functions were measured on the basis of the Japanese Orthopaedic Association (JOA) system 1 day before surgery and 3 months after surgery. The MacNab score at last follow-up was recorded to evaluate the early clinical efficacy. Complications during and after the operation were recorded to evaluate the safety of surgery. Results Two patients experienced abnormal sensations in the export nerve root zone postoperatively, which disappeared after 3 days of treatment with dehydration and administration of hormone (dexamethasone). Three cases of recurrence were observed at 6 months, 7 months, and 9 months postoperatively; they were scheduled to receive total laminectomy combined with bone grafting internal fixation. A total of 67 patients were followed up for 3–23 months and mean follow-up was 11.8 months. The VAS scores at postoperative 3 months and 1 year were significantly reduced compared to that before the operation, with significant differences between them (t=43.072, P<0.05; t=43.139, P<0.05). The JOA scores at last follow-up postoperatively was significantly higher than that before surgery (t=−60.312, P<0.05). At the last follow-up, 17 cases (25.3%) had excellent outcomes, 39 (58.2%) good, 7 (10.4%) fair, and 4 (5.9%) poor. Overall, 83.5% of patients had excellent or good rates

  5. Clinical results of XMR-assisted percutaneous transforaminal endoscopic lumbar discectomy

    PubMed Central

    2013-01-01

    Background Although percutaneous endoscopic lumbar discectomy (PELD) has shown favorable outcomes in the majority of lumbar discectomy cases, there were also some failures. The most common cause of failure is the incomplete removal of disc fragments. The skin entry point for the guide-needle trajectory and the optimal placement of the working sleeve are largely blind, which might lead to the inadequate removal of disc fragments. The objective of this study was to present our early experiences with image-guided PELD using a specially designed fluoroscope with magnetic resonance imaging-equipped operative suite (XMR) for the treatment of lumbar disc herniation. Methods This prospective study included 89 patients who had undergone PELD via the transforaminal approach using an XMR protocol. Pre- and postoperative examinations (at 12 weeks) included a detailed clinical history, visual analogue scale (VAS), Oswestry disability index (ODI), and radiological workups. The results were categorized as excellent, good, fair, and poor according to MacNab's criteria. At the final follow-up, the minimum follow-up time for the subjects was 2 years. The need for revision surgeries and postoperative complications were noted on follow-up. Results Postoperative mean ODI decreased from 67.4% to 5.61%. Mean VAS score for back and leg pain improved significantly from 4 to 2.3 and from 7.99 to 1.04, respectively. Four (4.49%) patients underwent a second-stage PELD after intraoperative XMR had shown remnant fragments after the first stage. As per MacNab's criteria, 76 patients (85.4%) showed excellent, 8 (8.89%) good, 3 (3.37%) fair, and 2 (2.25) poor results. Four (4.49%) patients had remnant disc fragments on XMR, which were removed during the same procedure. All of these patients had either highly migrated or sequestrated disc fragments preoperatively. Four (4.49%) other patients needed a second, open surgery due to symptomatic postoperative hematoma (n = 2) and recurrent disc

  6. In Silico Design and Analysis of TGFαL3-SEB Fusion Protein as “a New Antitumor Agent” Candidate by Ligand-Targeted Superantigens Technique

    PubMed Central

    Imani-Fooladi, Abbas Ali; Yousefi, Forough; Mousavi, Seyed Fazloallah; Amani, Jafar

    2014-01-01

    Background Bacterial superantigen Staphylococcal Enterotoxins (SEs), has stimulated polyclonal T cells irrespective of their antigen specificity, resulted a massive release of cytokines, and suggested that they could be assigned as a candidate of new antitumor agents. Recent attempts have done to specifically target superantigens towards tumors, subsequently Monoclonal antibodies and tumor-related ligands have employed as targeting molecules of superantigen for the preclinical treatment of different tumors. Here, we have evaluated TGFαL3-SEB fusion protein as a new antitumor candidate by genetically fusing the third loop of transforming growth factor alpha (TGFαL3) to Staphylococcal Enterotoxin type B. Methods An in silico techniques have launched to characterize the properties and structure of the protein, before initiating the experimental study, we have predicted physicochemical properties, structures, stability, MHC binding properties and ligand-receptor interaction of this chimeric protein by means of computational bioinformatics tools and servers. Results Our results have indicated codon adaptation index of tgfαl3-seb fusion gene has increased from 0.5 in the wild type sequences to 0.85 in the chimeric optimized gene. The mfold data has shown the tgfαl3-seb mRNA was stable enough for efficient translation in the new host. Based on Ramachandran plot TGFαL3-SEB has classified as a stable fusion protein. Our result has shown fusing of TGFaL3 in N-terminal of the TGFαL3-SEB construct, had no effects on MHC binding and subsequently superantigenic activity of SEB. Finally based on ligand-receptor docking the binding ability of TGFaL3 was strong enough to its receptor, so TGFαL3-SEB could be assigned as a new antitumor candidate in cancer immunotherapy. Conclusion Our results have proposed that TGFαL3-SEB was a stable fusion protein with proper affinity to its receptor that overexpressed in various human carcinomas, so it could generate potent immune

  7. Hemorrhagic lumbar synovial facet cyst secondary to transforaminal epidural injection: A case report and review of the literature

    PubMed Central

    Elgafy, Hossein; Peters, Nicholas; Lea, Justin E; Wetzel, Robert M

    2016-01-01

    A 64-year-old-female presented with progressive left foot weakness, low back and radicular pain after a left sided S1 transforaminal epidural steroid injection (ESI). Magnetic resonance imaging revealed left side L5-S1 large extradural heterogeneous mass with layering areas suggesting different stages of hematoma formation. Past medical history was significant for peripheral vascular disease and transient ischemic attacks, for which she took aspirin and clopidogrel (antiplatelet agent). These medications were discontinued one week prior to ESI. Although synovial cysts associated with facet arthropathy are common, hemorrhagic cyst is not. To the best of the authors’ knowledge, this is the first reported case of symptomatic hemorrhagic lumbar facet synovial cyst following ESI on a patient taking anti-platelet medications. PMID:27458557

  8. Hemorrhagic lumbar synovial facet cyst secondary to transforaminal epidural injection: A case report and review of the literature.

    PubMed

    Elgafy, Hossein; Peters, Nicholas; Lea, Justin E; Wetzel, Robert M

    2016-07-18

    A 64-year-old-female presented with progressive left foot weakness, low back and radicular pain after a left sided S1 transforaminal epidural steroid injection (ESI). Magnetic resonance imaging revealed left side L5-S1 large extradural heterogeneous mass with layering areas suggesting different stages of hematoma formation. Past medical history was significant for peripheral vascular disease and transient ischemic attacks, for which she took aspirin and clopidogrel (antiplatelet agent). These medications were discontinued one week prior to ESI. Although synovial cysts associated with facet arthropathy are common, hemorrhagic cyst is not. To the best of the authors' knowledge, this is the first reported case of symptomatic hemorrhagic lumbar facet synovial cyst following ESI on a patient taking anti-platelet medications. PMID:27458557

  9. Donor site morbidity following iliac crest bone harvesting for cervical fusion: a comparison between minimally invasive and open techniques

    PubMed Central

    Pollock, Raymond; Bhatia, Chandra; Chuter, Graham; Lingutla, Kiran; Budithi, Chakravarty; Krishna, Manoj

    2008-01-01

    We have studied the occurrence of donor site morbidity, cosmesis and overall satisfaction with graft procedure in 76 patients who had undergone iliac crest bone harvesting for anterior cervical discectomy and fusion (ACDF). Totally 24 patients underwent an open procedure and 52 a minimally invasive trephine harvesting method. Although our study demonstrated substantial donor site pain and its effect on ambulation in both groups, this was of limited duration. Two patients, one in each group, suffered long-term pain that was eventually resolved. Totally 8.3% of patients in the open group suffered minor complications and 11.5% in the trephine group. There were two cases of meralgia parasthetica. There were no major complications in either group. There was no statistically significant difference in morbidity between the open and trephine groups. There was a trend towards significance (P = 0.076) for pain at the donor site, with less pain reported by patients who underwent the trephine procedure for harvesting. PMID:18389294

  10. Fundus image fusion in EYEPLAN software: An evaluation of a novel technique for ocular melanoma radiation treatment planning

    SciTech Connect

    Daftari, Inder K.; Mishra, Kavita K.; O'Brien, Joan M.; and others

    2010-10-15

    Purpose: The purpose of this study is to evaluate a novel approach for treatment planning using digital fundus image fusion in EYEPLAN for proton beam radiation therapy (PBRT) planning for ocular melanoma. The authors used a prototype version of EYEPLAN software, which allows for digital registration of high-resolution fundus photographs. The authors examined the improvement in tumor localization by replanning with the addition of fundus photo superimposition in patients with macular area tumors. Methods: The new version of EYEPLAN (v3.05) software allows for the registration of fundus photographs as a background image. This is then used in conjunction with clinical examination, tantalum marker clips, surgeon's mapping, and ultrasound to draw the tumor contour accurately. In order to determine if the fundus image superimposition helps in tumor delineation and treatment planning, the authors identified 79 patients with choroidal melanoma in the macular location that were treated with PBRT. All patients were treated to a dose of 56 GyE in four fractions. The authors reviewed and replanned all 79 macular melanoma cases with superimposition of pretreatment and post-treatment fundus imaging in the new EYEPLAN software. For patients with no local failure, the authors analyzed whether fundus photograph fusion accurately depicted and confirmed tumor volumes as outlined in the original treatment plan. For patients with local failure, the authors determined whether the addition of the fundus photograph might have benefited in terms of more accurate tumor volume delineation. Results: The mean follow-up of patients was 33.6{+-}23 months. Tumor growth was seen in six eyes of the 79 macular lesions. All six patients were marginal failures or tumor miss in the region of dose fall-off, including one patient with both in-field recurrence as well as marginal. Among the six recurrences, three were managed by enucleation and one underwent retreatment with proton therapy. Three

  11. Label fusion strategy selection.

    PubMed

    Robitaille, Nicolas; Duchesne, Simon

    2012-01-01

    Label fusion is used in medical image segmentation to combine several different labels of the same entity into a single discrete label, potentially more accurate, with respect to the exact, sought segmentation, than the best input element. Using simulated data, we compared three existing label fusion techniques-STAPLE, Voting, and Shape-Based Averaging (SBA)-and observed that none could be considered superior depending on the dissimilarity between the input elements. We thus developed an empirical, hybrid technique called SVS, which selects the most appropriate technique to apply based on this dissimilarity. We evaluated the label fusion strategies on two- and three-dimensional simulated data and showed that SVS is superior to any of the three existing methods examined. On real data, we used SVS to perform fusions of 10 segmentations of the hippocampus and amygdala in 78 subjects from the ICBM dataset. SVS selected SBA in almost all cases, which was the most appropriate method overall. PMID:22518113

  12. Image computing techniques to extrapolate data for dust tracking in case of an experimental accident simulation in a nuclear fusion plant.

    PubMed

    Camplani, M; Malizia, A; Gelfusa, M; Barbato, F; Antonelli, L; Poggi, L A; Ciparisse, J F; Salgado, L; Richetta, M; Gaudio, P

    2016-01-01

    In this paper, a preliminary shadowgraph-based analysis of dust particles re-suspension due to loss of vacuum accident (LOVA) in ITER-like nuclear fusion reactors has been presented. Dust particles are produced through different mechanisms in nuclear fusion devices, one of the main issues is that dust particles are capable of being re-suspended in case of events such as LOVA. Shadowgraph is based on an expanded collimated beam of light emitted by a laser or a lamp that emits light transversely compared to the flow field direction. In the STARDUST facility, the dust moves in the flow, and it causes variations of refractive index that can be detected by using a CCD camera. The STARDUST fast camera setup allows to detect and to track dust particles moving in the vessel and then to obtain information about the velocity field of dust mobilized. In particular, the acquired images are processed such that per each frame the moving dust particles are detected by applying a background subtraction technique based on the mixture of Gaussian algorithm. The obtained foreground masks are eventually filtered with morphological operations. Finally, a multi-object tracking algorithm is used to track the detected particles along the experiment. For each particle, a Kalman filter-based tracker is applied; the particles dynamic is described by taking into account position, velocity, and acceleration as state variable. The results demonstrate that it is possible to obtain dust particles' velocity field during LOVA by automatically processing the data obtained with the shadowgraph approach. PMID:26827318

  13. Image computing techniques to extrapolate data for dust tracking in case of an experimental accident simulation in a nuclear fusion plant

    NASA Astrophysics Data System (ADS)

    Camplani, M.; Malizia, A.; Gelfusa, M.; Barbato, F.; Antonelli, L.; Poggi, L. A.; Ciparisse, J. F.; Salgado, L.; Richetta, M.; Gaudio, P.

    2016-01-01

    In this paper, a preliminary shadowgraph-based analysis of dust particles re-suspension due to loss of vacuum accident (LOVA) in ITER-like nuclear fusion reactors has been presented. Dust particles are produced through different mechanisms in nuclear fusion devices, one of the main issues is that dust particles are capable of being re-suspended in case of events such as LOVA. Shadowgraph is based on an expanded collimated beam of light emitted by a laser or a lamp that emits light transversely compared to the flow field direction. In the STARDUST facility, the dust moves in the flow, and it causes variations of refractive index that can be detected by using a CCD camera. The STARDUST fast camera setup allows to detect and to track dust particles moving in the vessel and then to obtain information about the velocity field of dust mobilized. In particular, the acquired images are processed such that per each frame the moving dust particles are detected by applying a background subtraction technique based on the mixture of Gaussian algorithm. The obtained foreground masks are eventually filtered with morphological operations. Finally, a multi-object tracking algorithm is used to track the detected particles along the experiment. For each particle, a Kalman filter-based tracker is applied; the particles dynamic is described by taking into account position, velocity, and acceleration as state variable. The results demonstrate that it is possible to obtain dust particles' velocity field during LOVA by automatically processing the data obtained with the shadowgraph approach.

  14. A Geostatistical Data Fusion Technique for Merging Remote Sensing and Ground-Based Observations of Aerosol Optical Thickness

    NASA Technical Reports Server (NTRS)

    Chatterjee, Abhishek; Michalak, Anna M.; Kahn, Ralph A.; Paradise, Susan R.; Braverman, Amy J.; Miller, Charles E.

    2010-01-01

    Particles in the atmosphere reflect incoming sunlight, tending to cool the Earth below. Some particles, such as soot, also absorb sunlight, which tens to warm the ambient atmosphere. Aerosol optical depth (AOD) is a measure of the amount of particulate matter in the atmosphere, and is a key input to computer models that simulate and predict Earth's changing climate. The global AOD products from the Multi-angle Imaging SpectroRadiometer (MISR) and the MODerate resolution Imaging Spectroradiometer (MODIS), both of which fly on the NASA Earth Observing System's Terra satellite, provide complementary views of the particles in the atmosphere. Whereas MODIS offers global coverage about four times as frequent as MISR, the multi-angle data makes it possible to separate the surface and atmospheric contributions to the observed top-of-atmosphere radiances, and also to more effectively discriminate particle type. Surface-based AERONET sun photometers retrieve AOD with smaller uncertainties than the satellite instruments, but only at a few fixed locations. So there are clear reasons to combine these data sets in a way that takes advantage of their respective strengths. This paper represents an effort at combining MISR, MODIS and AERONET AOD products over the continental US, using a common spatial statistical technique called kriging. The technique uses the correlation between the satellite data and the "ground-truth" sun photometer observations to assign uncertainty to the satellite data on a region-by-region basis. The larger fraction of the sun photometer variance that is duplicated by the satellite data, the higher the confidence assigned to the satellite data in that region. In the Western and Central US, MISR AOD correlation with AERONET are significantly higher than those with MODIS, likely due to bright surfaces in these regions, which pose greater challenges for the single-view MODIS retrievals. In the east, MODIS correlations are higher, due to more frequent sampling

  15. A fusion of top-down and bottom-up modeling techniques to constrain regional scale carbon budgets

    NASA Astrophysics Data System (ADS)

    Goeckede, M.; Turner, D. P.; Michalak, A. M.; Vickers, D.; Law, B. E.

    2009-12-01

    The effort to constrain regional scale carbon budgets benefits from assimilating as many high quality data sources as possible in order to reduce uncertainties. Two of the most common approaches used in this field, bottom-up and top-down techniques, both have their strengths and weaknesses, and partly build on very different sources of information to train, drive, and validate the models. Within the context of the ORCA2 project, we follow both bottom-up and top-down modeling strategies with the ultimate objective of reconciling their surface flux estimates. The ORCA2 top-down component builds on a coupled WRF-STILT transport module that resolves the footprint function of a CO2 concentration measurement in high temporal and spatial resolution. Datasets involved in the current setup comprise GDAS meteorology, remote sensing products, VULCAN fossil fuel inventories, boundary conditions from CarbonTracker, and high-accuracy time series of atmospheric CO2 concentrations. Surface fluxes of CO2 are normally provided through a simple diagnostic model which is optimized against atmospheric observations. For the present study, we replaced the simple model with fluxes generated by an advanced bottom-up process model, Biome-BGC, which uses state-of-the-art algorithms to resolve plant-physiological processes, and 'grow' a biosphere based on biogeochemical conditions and climate history. This approach provides a more realistic description of biomass and nutrient pools than is the case for the simple model. The process model ingests various remote sensing data sources as well as high-resolution reanalysis meteorology, and can be trained against biometric inventories and eddy-covariance data. Linking the bottom-up flux fields to the atmospheric CO2 concentrations through the transport module allows evaluating the spatial representativeness of the BGC flux fields, and in that way assimilates more of the available information than either of the individual modeling techniques alone

  16. Masked-backlighter technique used to simultaneously image x-ray absorption and x-ray emission from an inertial confinement fusion plasma

    SciTech Connect

    Marshall, F. J. Radha, P. B.

    2014-11-15

    A method to simultaneously image both the absorption and the self-emission of an imploding inertial confinement fusion plasma has been demonstrated on the OMEGA Laser System. The technique involves the use of a high-Z backlighter, half of which is covered with a low-Z material, and a high-speed x-ray framing camera aligned to capture images backlit by this masked backlighter. Two strips of the four-strip framing camera record images backlit by the high-Z portion of the backlighter, while the other two strips record images aligned with the low-Z portion of the backlighter. The emission from the low-Z material is effectively eliminated by a high-Z filter positioned in front of the framing camera, limiting the detected backlighter emission to that of the principal emission line of the high-Z material. As a result, half of the images are of self-emission from the plasma and the other half are of self-emission plus the backlighter. The advantage of this technique is that the self-emission simultaneous with backlighter absorption is independently measured from a nearby direction. The absorption occurs only in the high-Z backlit frames and is either spatially separated from the emission or the self-emission is suppressed by filtering, or by using a backlighter much brighter than the self-emission, or by subtraction. The masked-backlighter technique has been used on the OMEGA Laser System to simultaneously measure the emission profiles and the absorption profiles of polar-driven implosions.

  17. Masked-backlighter technique used to simultaneously image x-ray absorption and x-ray emission from an inertial confinement fusion plasma.

    PubMed

    Marshall, F J; Radha, P B

    2014-11-01

    A method to simultaneously image both the absorption and the self-emission of an imploding inertial confinement fusion plasma has been demonstrated on the OMEGA Laser System. The technique involves the use of a high-Z backlighter, half of which is covered with a low-Z material, and a high-speed x-ray framing camera aligned to capture images backlit by this masked backlighter. Two strips of the four-strip framing camera record images backlit by the high-Z portion of the backlighter, while the other two strips record images aligned with the low-Z portion of the backlighter. The emission from the low-Z material is effectively eliminated by a high-Z filter positioned in front of the framing camera, limiting the detected backlighter emission to that of the principal emission line of the high-Z material. As a result, half of the images are of self-emission from the plasma and the other half are of self-emission plus the backlighter. The advantage of this technique is that the self-emission simultaneous with backlighter absorption is independently measured from a nearby direction. The absorption occurs only in the high-Z backlit frames and is either spatially separated from the emission or the self-emission is suppressed by filtering, or by using a backlighter much brighter than the self-emission, or by subtraction. The masked-backlighter technique has been used on the OMEGA Laser System to simultaneously measure the emission profiles and the absorption profiles of polar-driven implosions. PMID:25430361

  18. Inertial Confinement fusion targets

    NASA Technical Reports Server (NTRS)

    Hendricks, C. D.

    1982-01-01

    Inertial confinement fusion (ICF) targets are made as simple flat discs, as hollow shells or as complicated multilayer structures. Many techniques were devised for producing the targets. Glass and metal shells are made by using drop and bubble techniques. Solid hydrogen shells are also produced by adapting old methods to the solution of modern problems. Some of these techniques, problems, and solutions are discussed. In addition, the applications of many of the techniques to fabrication of ICF targets is presented.

  19. Cervical anterior hybrid technique with bi-level Bryan artificial disc replacement and adjacent segment fusion for cervical myelopathy over three consecutive segments.

    PubMed

    Chen, Jiang; Xu, Lin; Jia, Yu-Song; Sun, Qi; Li, Jin-Yu; Zheng, Chen-Ying; Bai, Chun-Xiao; Yu, Qin-Sheng

    2016-05-01

    This study aimed to assess the preliminary clinical efficacy and feasibility of the hybrid technique for multilevel cervical myelopathy. Considering the many shortcomings of traditional treatment methods for multilevel cervical degenerative myelopathy, hybrid surgery (bi-level Bryan artificial disc [Medtronic Sofamor Danek, Memphis, TN, USA] replacement and anterior cervical discectomy and fusion) should be considered. Between March 2006 and November 2012, 108 patients (68 men and 40 women, average age 45years) underwent hybrid surgery. Based on the Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), and Odom's criteria, the clinical symptoms and neurological function before and after surgery were evaluated. Mean surgery duration was 90minutes, with average blood loss of 30mL. Mean follow-up duration was 36months. At the final follow-up, the mean JOA (± standard deviation) scores were significantly higher compared with preoperative values (15.08±1.47 versus 9.18±1.22; P<0.01); meanwhile, NDI values were markedly decreased (12.32±1.03 versus 42.68±1.83; P<0.01). Using Odom's criteria, the clinical outcomes were rated as excellent (76 patients), good (22 patients), fair (six patients), and poor (four patients). These findings indicate that the hybrid method provides an effective treatment for cervical myelopathy over three consecutive segments, ensuring a good clinical outcome. PMID:26758702

  20. New cell biological applications of the laser microbeam technique: the microdissection and skinning of muscle fibers and the perforation and fusion of sarcolemma vesicles.

    PubMed

    Veigel, C; Steubing, R W; Harim, A; Weber, C; Greulich, K O; Fink, R H

    1994-02-01

    In a novel approach, the laser microbeam technique was used to selectively perforate the sarcolemma of skeletal muscle fibers, to prepare fragments of myofibrillar bundles of very small dimensions, and to induce fusion of sarcolemma vesicles. Using a highly focused UV laser microbeam with an effective beam diameter of down to 0.5 micron, very small (< 3 microns) myofibrillar fragments with an intact sarcomere striation pattern were obtained. When small amounts of Ca2+ were released in the vicinity of such a fragment by laser-photolysis of the photolabile compound Ca(2+)-nitr-7 the bundle shortened due to the development of calcium-activated force. We also show that very small selected areas from myopathic single muscle cells can be dissected with a precision unmatched by other current techniques. The microbeam was also used to remove very small patches of the sarcolemma of murine skeletal muscle fibers so giving diffusional access to the myoplasmic interior and thus resulting in a "skinning" of the fiber. To ensure that such laser-skinned fiber segments were physiologically intact we determined the Ca(2+)-activated force and caffeine-induced Ca(2+)-release from the sarcoplasmic reticulum. The fibers showed normal characteristics for force production, Ca(2+)-release and uptake by the sarcoplasmic reticulum. To test the effects of the laser microbeam on the muscle membrane directly, we prepared sarcolemma vesicles of skeletal muscle fibers. The vesicles could be selectively perforated with single laser pulses to allow entry of fluorescein isothiocyanate (FITC)-dextran as a fluorescent marker. Adjacent vesicles were caused to fuse by a few pulses at low intensity of the laser microbeam.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7516289

  1. Acquired spondylolysis after spinal fusion.

    PubMed

    Brunet, J A; Wiley, J J

    1984-11-01

    Spondylolysis occurring after a spinal fusion is considered to result from operative damage to the pars interarticularis on both sides. Fourteen cases are reported, and compared with the 23 cases which have previously been published. The defects are usually recognised within five years of fusion, and usually occur immediately above the fusion mass. Other contributory causes may be: fatigue fracture from concentration of stress; damage and altered function of the posterior ligament complex; and degenerative disc disease immediately above or below the fusion. Fusion technique is critical, since virtually all cases occurred after posterior interlaminar fusions. This complication is easily overlooked in patients with recurrent back pain after an originally successful posterior spinal fusion. PMID:6501368

  2. A review: Reduced reoperation rate for multilevel lumbar laminectomies with noninstrumented versus instrumented fusions

    PubMed Central

    Epstein, Nancy Ellen

    2016-01-01

    Background: The reoperation rate, including for adjacent segment disease (ASD), is lower following multilevel lumbar laminectomy with noninstrumented versus instrumented fusions. Methods: This study reviews selected literature focusing on the reoperation rate, including for ASD, following multilevel laminectomies with noninstrumented versus instrumented fusions. Several prior studies document a 1.3–5.6% reoperation rate following multilevel laminectomy with/without noninstrumented fusions. Results: The reoperation rates for instrumented fusions, including for ASD, are substantially higher. One study cited a 12.2–18.5% frequency for reoperation following instrumented transforaminal lumbar and posterior lumbar interbody fusions (TLIF and PLIFs) at an average of 164 postoperative months. Another study cited a 9.9% reoperation rate for ASD 1 year following PLIF; this increased to 80% at 5 postoperative years. A further study compared 380 patients variously undergoing laminectomies/noninstrumented posterolateral fusions, laminectomies with instrumented fusions (PLFs), and laminectomies with instrumented PLF plus an interbody fusions; this study documented no significant differences in outcomes for any of these operations at 4 postoperative years. Furthermore, other series showed fusion rates for 1–2 level procedures which were often similar with or without instrumentation, while instrumentation increased reoperation rates and morbidity. Conclusions: Many studies document no benefit for adding instrumentation to laminectomies performed for degenerative disease, including spondylolisthesis. Reoperation rates for laminectomy alone/laminectomy with noninstrumented fusions vary from 1.3% to 5.6% whereas reoperation rates for ASD after instrumented PLIF was 80% at 5 postoperative years. This review should prompt spinal surgeons to reexamine when, why, and whether instrumentation is really necessary, particularly for treating degenerative lumbar disease. PMID:27274408

  3. Effects of extracellular calcium and surgical techniques on restoration of axonal continuity by polyethylene glycol fusion following complete cut or crush severance of rat sciatic nerves.

    PubMed

    Ghergherehchi, Cameron L; Bittner, George D; Hastings, Robert Louis; Mikesh, Michelle; Riley, D Colton; Trevino, Richard C; Schallert, Tim; Thayer, Wesley P; Sunkesula, Solomon Raju Bhupanapadu; Ha, Tu-Anh N; Munoz, Nicolas; Pyarali, Monika; Bansal, Aakarshita; Poon, Andrew D; Mazal, Alexander T; Smith, Tyler A; Wong, Nicole S; Dunne, Patrick J

    2016-03-01

    Complete crush or cut severance of sciatic nerve axons in rats and other mammals produces immediate loss of axonal continuity. Loss of locomotor functions subserved by those axons is restored only after months, if ever, by outgrowths regenerating at ∼1 mm/day from the proximal stumps of severed axonal segments. The distal stump of a severed axon typically begins to degenerate in 1-3 days. We recently developed a polyethylene glycol (PEG) fusion technology, consisting of sequential exposure of severed axonal ends to hypotonic Ca(2+) -free saline, methylene blue, PEG in distilled water, and finally Ca(2+) -containing isotonic saline. This study examines factors that affect the PEG fusion restoration of axonal continuity within minutes, as measured by conduction of action potentials and diffusion of an intracellular fluorescent dye across the lesion site of rat sciatic nerves completely cut or crush severed in the midthigh. Also examined are factors that affect the longer-term PEG fusion restoration of lost behavioral functions within days to weeks, as measured by the sciatic functional index. We report that exposure of cut-severed axonal ends to Ca(2+) -containing saline prior to PEG fusion and stretch/tension of proximal or distal axonal segments of cut-severed axons decrease PEG fusion success. Conversely, trimming cut-severed ends in Ca(2+) -free saline just prior to PEG fusion increases PEG fusion success. PEG fusion prevents or retards the Wallerian degeneration of cut-severed axons, as assessed by measures of axon diameter and G ratio. PEG fusion may produce a paradigm shift in the treatment of peripheral nerve injuries. © 2016 Wiley Periodicals, Inc. PMID:26728662

  4. Comparative Effectivenesses of Pulsed Radiofrequency and Transforaminal Steroid Injection for Radicular Pain due to Disc Herniation: a Prospective Randomized Trial

    PubMed Central

    2016-01-01

    Transforaminal Epidural steroid injections (TFESI) have been widely adopted to alleviate and control radicular pain in accord with current guidelines. However, sometimes repeated steroid injections have adverse effects, and thus, this prospective randomized trial was undertaken to compare the effectivenesses of pulsed radiofrequency (PRF) administered to a targeted dorsal root ganglion (DRG) and TFESI for the treatment of radicular pain due to disc herniation. Subjects were recruited when first proved unsuccessful (defined as a score of > 4 on a visual analogue scale (VAS; 0-10 mm) and of > 30% according to the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI)). Forty-four patients that met the inclusion criteria were enrolled. The 38 subjects were randomly assigned to receive either PRF (PRF group; n = 19) or additional TFESI (TFESI group; n = 19) and were then followed for 2, 4, 8, and 12 weeks. To evaluate pain intensity were assessed by VAS. ODI and NDI were applied to evaluate functional disability. Mean VAS scores for cervical and lumbar radicular pain were significantly lower 12 weeks after treatment in both study groups. NDI and ODI scores also declined after treatment. However, no statistically significant difference was observed between the PRF and TFESI groups in terms of VAS, ODI, or NDI scores at any time during follow-up. PRF administered to a DRG might be as effective as TFESI in terms of attenuating radicular pain caused by disc herniation, and its use would avoid the adverse effects of steroid. PMID:27478346

  5. Comparative Effectivenesses of Pulsed Radiofrequency and Transforaminal Steroid Injection for Radicular Pain due to Disc Herniation: a Prospective Randomized Trial.

    PubMed

    Lee, Dong Gyu; Ahn, Sang-Ho; Lee, Jungwon

    2016-08-01

    Transforaminal Epidural steroid injections (TFESI) have been widely adopted to alleviate and control radicular pain in accord with current guidelines. However, sometimes repeated steroid injections have adverse effects, and thus, this prospective randomized trial was undertaken to compare the effectivenesses of pulsed radiofrequency (PRF) administered to a targeted dorsal root ganglion (DRG) and TFESI for the treatment of radicular pain due to disc herniation. Subjects were recruited when first proved unsuccessful (defined as a score of > 4 on a visual analogue scale (VAS; 0-10 mm) and of > 30% according to the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI)). Forty-four patients that met the inclusion criteria were enrolled. The 38 subjects were randomly assigned to receive either PRF (PRF group; n = 19) or additional TFESI (TFESI group; n = 19) and were then followed for 2, 4, 8, and 12 weeks. To evaluate pain intensity were assessed by VAS. ODI and NDI were applied to evaluate functional disability. Mean VAS scores for cervical and lumbar radicular pain were significantly lower 12 weeks after treatment in both study groups. NDI and ODI scores also declined after treatment. However, no statistically significant difference was observed between the PRF and TFESI groups in terms of VAS, ODI, or NDI scores at any time during follow-up. PRF administered to a DRG might be as effective as TFESI in terms of attenuating radicular pain caused by disc herniation, and its use would avoid the adverse effects of steroid. PMID:27478346

  6. A Preliminary Report on the CO2 Laser for Lumbar Fusion: Safety, Efficacy and Technical Considerations

    PubMed Central

    Villavicencio, Alan T; Babuska, Jason M; Nelson, Ewell L; Mason, Alexander; Rajpal, Sharad

    2015-01-01

    The purpose of this study was to evaluate potential technical advantages of the CO2 laser technology in mini-open transforaminal lumbar interbody fusion (TLIF) surgeries and report our preliminary clinical data on the safety and clinical outcomes. There is currently no literature discussing the recently redeveloped CO2 laser technology application for lumbar fusion. Safety and clinical outcomes were compared between two groups: 24 patients that underwent CO2 laser-assisted one-level TLIF surgeries and 30 patients that underwent standard one-level TLIF surgeries without the laser. There were no neural thermal injuries or other intraoperative laser-related complications encountered in this cohort of patients. At a mean follow-up of 17.4 months, significantly reduced lower back pain scores (P=0.013) were reported in the laser-assisted patient group compared to a standard fusion patient group. Lower extremity radicular pain intensity scores were similar in both groups. Laser-assisted TLIF surgeries showed a tendency (P = 0.07) of shorter operative times that was not statistically significant. Based on this preliminary clinical report, the safety of the CO2 laser device for lumbar fusion surgeries was assessed. There were no neural thermal injuries or other intraoperative laser-related complications encountered in this cohort of patients. Further investigation of CO2 laser-assisted lumbar fusion procedures is warranted in order to evaluate its effect on clinical outcomes. PMID:26180686

  7. Fusion breeder

    SciTech Connect

    Moir, R.W.

    1982-04-20

    The fusion breeder is a fusion reactor designed with special blankets to maximize the transmutation by 14 MeV neutrons of uranium-238 to plutonium or thorium to uranium-233 for use as a fuel for fission reactors. Breeding fissile fuels has not been a goal of the US fusion energy program. This paper suggests it is time for a policy change to make the fusion breeder a goal of the US fusion program and the US nuclear energy program. The purpose of this paper is to suggest this policy change be made and tell why it should be made, and to outline specific research and development goals so that the fusion breeder will be developed in time to meet fissile fuel needs.

  8. Evaluation of Functional Outcomes in Individuals 10 Years after Posterior Lumbar Interbody Fusion with Corundum Implants and Decompression: A Comparison of 2 Surgical Techniques

    PubMed Central

    Truszczyńska, Aleksandra; Rąpała, Kazimierz; Łukawski, Stanislaw; Trzaskoma, Zbigniew; Tarnowski, Adam; Drzal-Grabiec, Justyna; Cabak, Anna

    2014-01-01

    Background The purpose of this study was to evaluate lumbar spine-related functional disability in individuals 10 years after lumbar decompression and lumbar decompression with posterior lumbar interbody fusion (PLIF) with corundum implants surgery for degenerative stenosis and to compare the long-term outcome of these 2 surgical techniques. Material/Methods From 1998 to 2002, 100 patients with single-level lumbar stenosis were surgically treated. The patients were randomly divided into 2 groups that did not differ in terms of clinical or neurological symptoms. Group A consisted of 50 patients who were treated with PLIF and the use of porous ceramic corundum implants; the mean age was 57.74 and BMI was 27.34. Group B consisted of 50 patients treated with decompression by fenestration; mean age was 51.28 and the mean BMI was 28.84. Results There was no statistical significance regarding age, BMI, and sex. Both treatments revealed significant improvements. In group A, ODI decreased from 41.01% to 14.3% at 1 year and 16.3 at 10 years. In group B, ODI decreased from 63.8% to 18.36% at 1 year and 22.36% at 10 years. The difference between groups was statistically significant. There were no differences between the groups regarding the Rolland-Morris disability questionnaire and VAS at 1 and 10 years after surgery. Conclusions Long-term results evaluated according to the ODI, the Rolland-Morris disability questionnaire, and the VAS showed that the both methods significantly reduce patient disability, and this was maintained during next 10 years. The less invasive fenestration procedure was only slightly less favorable than surgical treatment of stenosis by both PLIF with corundum implants and decompression. PMID:25106708

  9. Fusion Implementation

    SciTech Connect

    J.A. Schmidt

    2002-02-20

    If a fusion DEMO reactor can be brought into operation during the first half of this century, fusion power production can have a significant impact on carbon dioxide production during the latter half of the century. An assessment of fusion implementation scenarios shows that the resource demands and waste production associated with these scenarios are manageable factors. If fusion is implemented during the latter half of this century it will be one element of a portfolio of (hopefully) carbon dioxide limiting sources of electrical power. It is time to assess the regional implications of fusion power implementation. An important attribute of fusion power is the wide range of possible regions of the country, or countries in the world, where power plants can be located. Unlike most renewable energy options, fusion energy will function within a local distribution system and not require costly, and difficult, long distance transmission systems. For example, the East Coast of the United States is a prime candidate for fusion power deployment by virtue of its distance from renewable energy sources. As fossil fuels become less and less available as an energy option, the transmission of energy across bodies of water will become very expensive. On a global scale, fusion power will be particularly attractive for regions separated from sources of renewable energy by oceans.

  10. Cellulose binding domain fusion proteins

    DOEpatents

    Shoseyov, O.; Yosef, K.; Shpiegl, I.; Goldstein, M.A.; Doi, R.H.

    1998-02-17

    A cellulose binding domain (CBD) having a high affinity for crystalline cellulose and chitin is disclosed, along with methods for the molecular cloning and recombinant production. Fusion products comprising the CBD and a second protein are likewise described. A wide range of applications are contemplated for both the CBD and the fusion products, including drug delivery, affinity separations, and diagnostic techniques. 16 figs.

  11. Cellulose binding domain fusion proteins

    DOEpatents

    Shoseyov, Oded; Shpiegl, Itai; Goldstein, Marc A.; Doi, Roy H.

    1998-01-01

    A cellulose binding domain (CBD) having a high affinity for crystalline cellulose and chitin is disclosed, along with methods for the molecular cloning and recombinant production thereof. Fusion products comprising the CBD and a second protein are likewise described. A wide range of applications are contemplated for both the CBD and the fusion products, including drug delivery, affinity separations, and diagnostic techniques.

  12. Image fusion

    NASA Technical Reports Server (NTRS)

    Pavel, M.

    1993-01-01

    The topics covered include the following: a system overview of the basic components of a system designed to improve the ability of a pilot to fly through low-visibility conditions such as fog; the role of visual sciences; fusion issues; sensor characterization; sources of information; image processing; and image fusion.

  13. Significant Improvement of Puncture Accuracy and Fluoroscopy Reduction in Percutaneous Transforaminal Endoscopic Discectomy With Novel Lumbar Location System

    PubMed Central

    Fan, Guoxin; Guan, Xiaofei; Zhang, Hailong; Wu, Xinbo; Gu, Xin; Gu, Guangfei; Fan, Yunshan; He, Shisheng

    2015-01-01

    Abstract Prospective nonrandomized control study. The study aimed to investigate the implication of the HE's Lumbar LOcation (HELLO) system in improving the puncture accuracy and reducing fluoroscopy in percutaneous transforaminal endoscopic discectomy (PTED). Percutaneous transforaminal endoscopic discectomy is one of the most popular minimally invasive spine surgeries that heavily depend on repeated fluoroscopy. Increased fluoroscopy will induce higher radiation exposure to surgeons and patients. Accurate puncture in PTED can be achieved by accurate preoperative location and definite trajectory. The HELLO system mainly consists of self-made surface locator and puncture-assisted device. The surface locator was used to identify the exact puncture target and the puncture-assisted device was used to optimize the puncture trajectory. Patients who had single L4/5 or L5/S1 lumbar intervertebral disc herniation and underwent PTED were included the study. Patients receiving the HELLO system were assigned in Group A, and those taking conventional method were assigned in Group B. Study primary endpoint was puncture times and fluoroscopic time, and the secondary endpoint was location time and operation time. A total of 62 patients who received PTED were included in this study. The average age was 45.35 ± 8.70 years in Group A and 46.61 ± 7.84 years in Group B (P = 0.552). There were no significant differences in gender, body mass index, conservative time, and surgical segment between the 2 groups (P > 0.05). The puncture time(s) were 1.19 ± 0.48 in Group A and 6.03 ± 1.87 in Group B (P < 0.001). The fluoroscopic times were 14.03 ± 2.54 in Group A and 25.19 ± 4.28 in Group B (P < 0.001). The preoperative location time was 4.67 ± 1.41 minutes in Group A and 6.98 ± 0.94 minutes in Group B (P < 0.001). The operation time was 79.42 ± 10.15 minutes in Group A and 89.65 ± 14.06 minutes in Group B (P

  14. Kinetic advantage of controlled intermediate nuclear fusion

    SciTech Connect

    Guo Xiaoming

    2012-09-26

    The dominated process of controlled fusion is to let nuclei gain enough kinetic energy to overcome Coulomb barrier. As a result, a fusion scheme can consider two factors in its design: to increase kinetic energy of nuclei and to alter the Coulomb barrier. Cold Fusion and Hot fusion are all one-factor schemes while Intermediate Fusion is a twofactors scheme. This made CINF kinetically superior. Cold Fusion reduces deuteron-deuteron distance, addressing Coulomb barrier, and Hot Fusion heat up plasma into extreme high temperature, addressing kinetic energy. Without enough kinetic energy made Cold Fusion skeptical. Extreme high temperature made Hot Fusion very difficult to engineer. Because CIFN addresses both factors, CIFN is a more promising technique to be industrialized.

  15. Kinetic advantage of controlled intermediate nuclear fusion

    NASA Astrophysics Data System (ADS)

    Guo, Xiaoming

    2012-09-01

    The dominated process of controlled fusion is to let nuclei gain enough kinetic energy to overcome Coulomb barrier. As a result, a fusion scheme can consider two factors in its design: to increase kinetic energy of nuclei and to alter the Coulomb barrier. Cold Fusion and Hot fusion are all one-factor schemes while Intermediate Fusion is a twofactors scheme. This made CINF kinetically superior. Cold Fusion reduces deuteron-deuteron distance, addressing Coulomb barrier, and Hot Fusion heat up plasma into extreme high temperature, addressing kinetic energy. Without enough kinetic energy made Cold Fusion skeptical. Extreme high temperature made Hot Fusion very difficult to engineer. Because CIFN addresses both factors, CIFN is a more promising technique to be industrialized.

  16. Transforaminal epidural steroid injections prevent the need for surgery in patients with sciatica secondary to lumbar disc herniation: a retrospective case series

    PubMed Central

    Manson, Neil A.; McKeon, Melissa D.; Abraham, Edward P.

    2013-01-01

    Background The median orthopedic surgery wait time in Canada is 33.7 weeks, thus alternative treatments for pathologies such as lumbar disc herniations (LDH) are needed. We sought to determine whether transforaminal epidural steroid injections (TFESIs) alleviate or merely delay the need for surgery. Methods We retrospectively reviewed the charts of patients with LDH who received TFESIs between September 2006 and July 2008. Patient demographics, level and side of pathology, workers’ compensation status, levels injected, treatment outcome and time from referral to treatment were evaluated. The primary outcome measure was the need for versus the avoidance of surgery. Results We included 91 patients in our analysis. Time from family physician referral to injection was 123 (standard deviation [SD] 88) days; no significant differences in wait times were found between TFESI patients and those requiring surgery. In all, 51 patients (22 women, 29 men) with a mean age of 45.8 (SD 10.2) years avoided surgery following TFESI, whereas 40 patients (16 women, 24 mean) with a mean age of 43.1 (SD 12.0) years proceeded to surgery within 189 (SD 125) days postinjection. In all, 15 patients received multiple injections, and of these, 9 did not require surgical intervention. Age, sex and level/side of pathology did not influence the treatment outcome. Workers’ compensation status influenced outcome significantly; these patients demonstrated less benefit from TFESI. Conclusion Transforaminal epidural steroid injections are an important treatment tool, preventing the need for surgery in 56% of patients with LDH. PMID:23351495

  17. Physics of Fusion Welding

    NASA Technical Reports Server (NTRS)

    Nunes, A. C., Jr.

    1986-01-01

    Applicabilities and limitations of three techniques analyzed. NASA technical memorandum discusses physics of electron-beam, gas/ tungsten-arc, and laser-beam welding. From comparison of capabilities and limitations of each technique with regard to various welding conditions and materials, possible to develop criteria for selecting best welding technique in specific application. All three techniques classified as fusion welding; small volume of workpiece melted by intense heat source. Heat source moved along seam, leaving in wake solid metal that joins seam edges together.

  18. Biomechanical comparison of a new stand-alone anterior lumbar interbody fusion cage with established fixation techniques – a three-dimensional finite element analysis

    PubMed Central

    Chen, Shih-Hao; Tai, Ching-Lung; Lin, Chien-Yu; Hsieh, Pang-Hsing; Chen, Weng-Pin

    2008-01-01

    Background Initial promise of a stand-alone interbody fusion cage to treat chronic back pain and restore disc height has not been realized. In some instances, a posterior spinal fixation has been used to enhance stability and increase fusion rate. In this manuscript, a new stand-alone cage is compared with conventional fixation methods based on the finite element analysis, with a focus on investigating cage-bone interface mechanics and stress distribution on the adjacent tissues. Methods Three trapezoid 8° interbody fusion cage models (dual paralleled cages, a single large cage, or a two-part cage consisting of a trapezoid box and threaded cylinder) were created with or without pedicle screws fixation to investigate the relative importance of the screws on the spinal segmental response. The contact stress on the facet joint, slip displacement of the cage on the endplate, and rotational angle of the upper vertebra were measured under different loading conditions. Results Simulation results demonstrated less facet stress and slip displacement with the maximal contact on the cage-bone interface. A stand-alone two-part cage had good slip behavior under compression, flexion, extension, lateral bending and torsion, as compared with the other two interbody cages, even with the additional posterior fixation. However, the two-part cage had the lowest rotational angles under flexion and torsion, but had no differences under extension and lateral bending. Conclusion The biomechanical benefit of a stand-alone two-part fusion cage can be justified. This device provided the stability required for interbody fusion, which supports clinical trials of the cage as an alternative to circumferential fixations. PMID:18559117

  19. Fusion Power.

    ERIC Educational Resources Information Center

    Dingee, David A.

    1979-01-01

    Discusses the extraordinary potential, the technical difficulties, and the financial problems that are associated with research and development of fusion power plants as a major source of energy. (GA)

  20. Adaptive sensor fusion using genetic algorithms

    SciTech Connect

    Fitzgerald, D.S.; Adams, D.G.

    1994-08-01

    Past attempts at sensor fusion have used some form of Boolean logic to combine the sensor information. As an alteniative, an adaptive ``fuzzy`` sensor fusion technique is described in this paper. This technique exploits the robust capabilities of fuzzy logic in the decision process as well as the optimization features of the genetic algorithm. This paper presents a brief background on fuzzy logic and genetic algorithms and how they are used in an online implementation of adaptive sensor fusion.

  1. Determination of physical membrane properties of plant cell protoplasts via the electrofusion technique: prediction of optimal fusion yields and protoplast viability.

    PubMed

    Mehrle, W; Naton, B; Hampp, R

    1990-04-01

    By variation of physical parameters (field strength, pulse duration) which result in electrofusion and electroporation, properties of the plasma membrane of different types of plant cell protoplasts were analyzed. The lower threshold for that field pulse intensity at which membrane breakdown occurred (recorded as fusion event) depended on pulse duration, protoplast size, and protoplast type (tobacco, oat; vacuolated, evacuolated). This fusion characteristic of plant protoplasts can also be taken as a measure of the charging process of the membrane and allows thus a non-invasive determination of the time constant and the specific membrane capacitance. Although the fusion yield was comparable at pulse duration/field strength couples of, e.g., 10 μs/1.5 kV*cm(-1) and 200 μs/0.5 kV*cm(-1), hybrid viability was not. Rates of cell wall regeneration and cell division of tobacco mesophyll protoplasts were not affected but may have been increased at short pulse duration/high field strength. Plating efficiency, in contrast, was significantly decreased with longer pulse duration at low field strengths. PMID:24232787

  2. Observations of membrane fusion in a liposome dispersion: the missing fusion intermediate?

    PubMed Central

    Foldvari, Marianna

    2015-01-01

    Early intermediate structures of liposome-liposome fusion events were captured by freeze-fracture electron microscopic (EM) technique. The images show the morphology of the fusion interface at several different stages of the fusion event. One of the intermediates was captured at a serendipitous stage of two vesicles’ membranes (both leaflets) merging and their contents starting to intermix clearly showing the fusion interface with a previously unseen fusion rim. From the morphological information a hypothetical sequence of the fusion event and corresponding lipid structural arrangements are described. PMID:26069726

  3. Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study

    PubMed Central

    Wu, Xin-bo; Fan, Guo-xin; Gu, Xin; Shen, Tu-gang; Guan, Xiao-fei; Hu, An-nan; Zhang, Hai-long; He, Shi-sheng

    2016-01-01

    Objectives: This study aimed to compare the learning curves of percutaneous endoscopic lumbar discectomy (PELD) in a transforaminal approach at the L4/5 and L5/S1 levels. Methods: We retrospectively reviewed the first 60 cases at the L4/5 level (Group I) and the first 60 cases at the L5/S1 level (Group II) of PELD performed by one spine surgeon. The patients were divided into subgroups A, B, and C (Group I: A cases 1–20, B cases 21–40, C cases 41–60; Group II: A cases 1–20, B cases 21–40, C cases 41–60). Operation time was thoroughly analyzed. Results: Compared with the L4/5 level, the learning curve of transforaminal PELD at the L5/S1 level was flatter. The mean operation times of Groups IA, IB, and IC were (88.75±17.02), (67.75±6.16), and (64.85±7.82) min, respectively. There was a significant difference between Groups A and B (P<0.05), but no significant difference between Groups B and C (P=0.20). The mean operation times of Groups IIA, IIB, and IIC were (117.25±13.62), (109.50±11.20), and (92.15±11.94) min, respectively. There was no significant difference between Groups A and B (P=0.06), but there was a significant difference between Groups B and C (P<0.05). There were 6 cases of postoperative dysesthesia (POD) in Group I and 2 cases in Group IIA (P=0.27). There were 2 cases of residual disc in Group I, and 4 cases in Group II (P=0.67). There were 3 cases of recurrence in Group I, and 2 cases in Group II (P>0.05). Conclusions: Compared with the L5/S1 level, the learning curve of PELD in a transforaminal approach at the L4/5 level was steeper, suggesting that the L4/5 level might be easier to master after short-term professional training. PMID:27381732

  4. Comparison of Clinical Efficacy Between Interlaminar and Transforaminal Epidural Injection in Patients With Axial Pain due to Cervical Disc Herniation.

    PubMed

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-01-01

    Transforaminal (TF) approach is preferred by physician to interlaminar (IL) approach because it can deliver injectates directly around nerve root and dorsal root ganglion, which is regarded as main pain sources. Axial neck pain is originated from sinuvertebral nerve located in ventral epidural spaces, which has been described to be related to central or paramedian disc herniation. It is very questionable that TF injection is also more effective than IL injection in the patients with axial neck or interscapular pain. This study was to evaluate clinical efficacy of cervical epidural injection in patients with axial pain due to cervical disc herniation and to compare the clinical outcomes between TF and IL approaches. Fifty-six and 52 patients who underwent IL and TF epidural injections, respectively, for axial neck/interscapular pain due to central or paramedian cervical disc herniation were included. Numeric Rating Scale (NRS) and Neck Disability Index (NDI) were compared between both groups at 2 and 8 weeks after treatment. Successful pain relief was defined if a 50% or more reduction of NRS score was achieved in comparison with pretreatment one. Successful functional improvement was defined if at least a 40% reduction of NDI was obtained. Overall, 79 (73.1%) and 57 (52.8%) among 108 patients showed successful pain relief at 2 and 8 weeks, respectively. Seventy-six (70.4%) and 52 (48.1%) had successful functional improvement at 2 and 8 weeks, respectively. The IL and TF groups showed no significant difference in proportion of successful results of NRS 2 weeks (73.2% vs 67.3%) and 8 weeks (48.2% vs 48.1%). Also, no significant difference was obtained in proportion of successful NDI between 2 groups at 2 weeks (75.0% vs 71.2%) and 8 weeks (53.6% vs 51.9%). Cervical epidural injection showed favorable results in 2 weeks and moderate results in 8 weeks in patients with axial pain due to cervical disc herniation. IL and TF showed no significant difference in clinical

  5. Laser fusion

    SciTech Connect

    Smit, W.A.; Boskma, P.

    1980-12-01

    Unrestricted laser fusion offers nations an opportunity to circumvent arms control agreements and develop thermonuclear weapons. Early laser weapons research sought a clean radiation-free bomb to replace the fission bomb, but this was deceptive because a fission bomb was needed to trigger the fusion reaction and additional radioactivity was induced by generating fast neutrons. As laser-implosion experiments focused on weapons physics, simulating weapons effects, and applications for new weapons, the military interest shifted from developing a laser-ignited hydrogen bomb to more sophisticated weapons and civilian applications for power generation. Civilian and military research now overlap, making it possible for several countries to continue weapons activities and permitting proliferation of nuclear weapons. These countries are reluctant to include inertial confinement fusion research in the Non-Proliferation Treaty. 16 references. (DCK)

  6. Feature-level sensor fusion

    NASA Astrophysics Data System (ADS)

    Peli, Tamar; Young, Mon; Knox, Robert; Ellis, Kenneth K.; Bennett, Frederick

    1999-03-01

    This paper describes two practical fusion techniques for automatic target cueing that combine features derived from each sensor data ta the object-level. In the hybrid fusion method each of the input sensor data is prescreened before the fusion stage. The cued fusion method assumes that one of the sensors is designated as a primary sensor, and thus ATC is only applied to its input data. If one of the sensors exhibits a higher Pd and/or a lower false alarm rate, it can be selected as the primary sensor. However, if the ground coverage can be segmented to regions in which one of the sensors is known to exhibit better performance, then the cued fusion can be applied locally/adaptively by switching the choice of a primary sensor. Otherwise, the cued fusion is applied both ways and the outputs of each cued mode are combined. Both fusion approaches use a back-end discrimination stage that is applied to a combined feature vector to reduce false alarms. The two fusion processes were applied to spectral and radar sensor data nd were shown to provide substantial false alarm reduction. The approaches are easily extendable to more than two sensors.

  7. Clinical Evaluation of Spatial Accuracy of a Fusion Imaging Technique Combining Previously Acquired Computed Tomography and Real-Time Ultrasound for Imaging of Liver Metastases

    SciTech Connect

    Hakime, Antoine Deschamps, Frederic; Garcia Marques de Carvalho, Enio; Teriitehau, Christophe; Auperin, Anne; De Baere, Thierry

    2011-04-15

    Purpose: This study was designed to evaluate the spatial accuracy of matching volumetric computed tomography (CT) data of hepatic metastases with real-time ultrasound (US) using a fusion imaging system (VNav) according to different clinical settings. Methods: Twenty-four patients with one hepatic tumor identified on enhanced CT and US were prospectively enrolled. A set of three landmarks markers was chosen on CT and US for image registration. US and CT images were then superimposed using the fusion imaging display mode. The difference in spatial location between the tumor visible on the CT and the US on the overlay images (reviewer no. 1, comment no. 2) was measured in the lateral, anterior-posterior, and vertical axis. The maximum difference (Dmax) was evaluated for different predictive factors.CT performed 1-30 days before registration versus immediately before. Use of general anesthesia for CT and US versus no anesthesia.Anatomic landmarks versus landmarks that include at least one nonanatomic structure, such as a cyst or a calcificationResultsOverall, Dmax was 11.53 {+-} 8.38 mm. Dmax was 6.55 {+-} 7.31 mm with CT performed immediately before VNav versus 17.4 {+-} 5.18 with CT performed 1-30 days before (p < 0.0001). Dmax was 7.05 {+-} 6.95 under general anesthesia and 16.81 {+-} 6.77 without anesthesia (p < 0.0015). Landmarks including at least one nonanatomic structure increase Dmax of 5.2 mm (p < 0.0001). The lowest Dmax (1.9 {+-} 1.4 mm) was obtained when CT and VNav were performed under general anesthesia, one immediately after the other. Conclusions: VNav is accurate when adequate clinical setup is carefully selected. Only under these conditions (reviewer no. 2), liver tumors not identified on US can be accurately targeted for biopsy or radiofrequency ablation using fusion imaging.

  8. Comparison of the Efficacy of Caudal, Interlaminar, and Transforaminal Epidural Injections in Managing Lumbar Disc Herniation: Is One Method Superior to the Other?

    PubMed Central

    Singh, Vijay; Pampati, Vidyasagar; Falco, Frank JE; Hirsch, Joshua A.

    2015-01-01

    Background Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. Methods This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 patients with lumbar disc herniation. There were 120 patients per trial either receiving local anesthetic alone (60 patients) or local anesthetic with steroids (60 patients). Results Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing chronic pain and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of steroids compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for pain relief in the steroid group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of patients. The proportion of patients nonresponsive to initial injections was also lower in the group for local anesthetic with steroid in the interlaminar trial. Conclusions The results of this assessment show significant improvement in patients suffering from chronic lumbar disc herniation with 3 lumbar epidural approaches with local anesthetic alone, or using steroids with long-term follow-up of up to 2 years, in a contemporary interventional pain management setting. PMID:25589942

  9. Inertial-confinement-fusion targets

    SciTech Connect

    Hendricks, C.D.

    1981-11-16

    Inertial confinement fusion (ICF) targets are made as simple flat discs, as hollow shells or as complicated multilayer structures. Many techniques have been devised for producing the targets. Glass and metal shells are made by using drop and bubble techniques. Solid hydrogen shells are also produced by adapting old methods to the solution of modern problems. Some of these techniques, problems and solutions are discussed. In addition, the applications of many of the techniques to fabrication of ICF targets is presented.

  10. Perioperative outcomes and adverse events of minimally invasive versus open posterior lumbar fusion: meta-analysis and systematic review.

    PubMed

    Goldstein, Christina L; Macwan, Kevin; Sundararajan, Kala; Rampersaud, Y Raja

    2016-03-01

    OBJECT The objective of this study was to determine the clinical comparative effectiveness and adverse event rates of posterior minimally invasive surgery (MIS) compared with open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF). METHODS A systematic review of the Medline, EMBASE, PubMed, Web of Science, and Cochrane databases was performed. A hand search of reference lists was conducted. Studies were reviewed by 2 independent assessors to identify randomized controlled trials (RCTs) or comparative cohort studies including at least 10 patients undergoing MIS or open TLIF/PLIF for degenerative lumbar spinal disorders and reporting at least 1 of the following: clinical outcome measure, perioperative clinical or process measure, radiographic outcome, or adverse events. Study quality was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol. When appropriate, a meta-analysis of outcomes data was conducted. RESULTS The systematic review and reference list search identified 3301 articles, with 26 meeting study inclusion criteria. All studies, including 1 RCT, were of low or very low quality. No significant difference regarding age, sex, surgical levels, or diagnosis was identified between the 2 cohorts (856 patients in the MIS cohort, 806 patients in the open cohort). The meta-analysis revealed changes in the perioperative outcomes of mean estimated blood loss, time to ambulation, and length of stay favoring an MIS approach by 260 ml (p < 0.00001), 3.5 days (p = 0.0006), and 2.9 days (p < 0.00001), respectively. Operative time was not significantly different between the surgical techniques (p = 0.78). There was no significant difference in surgical adverse events (p = 0.97), but MIS cases were significantly less likely to experience medical adverse events (risk ratio [MIS vs open] = 0.39, 95% confidence interval 0.23-0.69, p = 0.001). No difference in nonunion (p = 0.97) or reoperation rates (p = 0.97) was