Clinical value of transforaminal epidural steroid injection in lumbar radiculopathy.

PubMed

Leung, S M; Chau, W W; Law, S W; Fung, K Y

2015-10-01

To identify the diagnostic, therapeutic, and prognostic values of transforaminal epidural steroid injection as interventional rehabilitation for lumbar radiculopathy. Regional hospital, Hong Kong. A total of 232 Chinese patients with lumbar radiculopathy attributed to disc herniation or spinal stenosis received transforaminal epidural steroid injection between 1 January 2007 and 31 December 2011. Transforaminal epidural steroid injection. Patients' immediate response, response duration, proportion of patients requiring surgery, and risk factors affecting the responses to transforaminal epidural steroid injection for lumbar radiculopathy. Of the 232 patients, 218 (94.0%) had a single level of radiculopathy and 14 (6.0%) had multiple levels. L5 was the most commonly affected level. The immediate response rate to transforaminal epidural steroid injection was 80.2% in 186 patients with clinically diagnosed lumbar radiculopathy and magnetic resonance imaging of the lumbar spine suggesting nerve root compression. Of patients with single-level radiculopathy and multiple-level radiculopathy, 175 (80.3%) and 11 (78.6%) expressed an immediate response to transforaminal epidural steroid injection, respectively. The analgesic effect lasted for 1 to <3 weeks in 35 (15.1%) patients, for 3 to 12 weeks in 37 (15.9%) patients, and for more than 12 weeks in 92 (39.7%) patients. Of the 232 patients, 106 (45.7%) were offered surgery, with 65 (61.3%) undergoing operation, and with 42 (64.6%) requiring spinal fusion in addition to decompression surgery. Symptom chronicity was associated with poor immediate response to transforaminal epidural steroid injection, but not with duration of pain reduction. Poor response to transforaminal epidural steroid injection was not associated with a preceding industrial injury. The immediate response to transforaminal epidural steroid injection was approximately 80%. Transforaminal epidural steroid injection is a useful diagnostic, prognostic, and

Minimally Invasive Transforaminal Lumbar Interbody Fusion: Meta-analysis of the Fusion Rates. What is the Optimal Graft Material?

PubMed

Parajón, Avelino; Alimi, Marjan; Navarro-Ramirez, Rodrigo; Christos, Paul; Torres-Campa, Jose M; Moriguchi, Yu; Lang, Gernot; Härtl, Roger

2017-12-01

Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is an increasingly popular procedure with several potential advantages over traditional open TLIF. The current study aimed to compare fusion rates of different graft materials used in MIS-TLIF, via meta-analysis of the published literature. A Medline search was performed and a database was created including patient's type of graft, clinical outcome, fusion rate, fusion assessment modality, and duration of follow-up. Meta-analysis of the fusion rate was performed using StatsDirect software (StatsDirect Ltd, Cheshire, United Kingdom). A total of 1533 patients from 40 series were included. Fusion rates were high, ranging from 91.8% to 99%. The imaging modalities used to assess fusion were computed tomography scans (30%) and X-rays (70%). Comparison of all recombinant human bone morphogenetic protein (rhBMP) series with all non-rhBMP series showed fusion rates of 96.6% and 92.5%, respectively. The lowest fusion rate was seen with isolated use of autologous local bone (91.8%). The highest fusion rate was observed with combination of autologous local bone with bone extender and rhBMP (99.1%). The highest fusion rate without the use of BMP was seen with autologous local bone + bone extender (93.1%). The reported complication rate ranged from 0% to 35.71%. Clinical improvement was observed in all studies. Fusion rates are generally high with MIS-TLIF regardless of the graft material used. Given the potential complications of iliac bone harvesting and rhBMP, use of other bone graft options for MIS-TLIF is reasonable. The highest fusion rate without the use of rhBMP was seen with autologous local bone plus bone extender (93.1%). Published by Oxford University Press on behalf of Congress of Neurological Surgeons 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Transforaminal Lumbar Puncture: An Alternative Technique in Patients with Challenging Access.

PubMed

Nascene, D R; Ozutemiz, C; Estby, H; McKinney, A M; Rykken, J B

2018-05-01

Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1. The L1-2 level was used in 2; the L2-3 level, in 10; the L3-4 level, in 12; and the L4-5 level, in 2 procedures. Post-lumbar puncture headache was observed on 4 occasions, which resolved without blood patching. One patient felt heat and pain at the injection site that resolved spontaneously within hours. One patient had radicular pain that resolved with conservative treatment. Transforaminal lumbar puncture may become an effective alternative to classic interlaminar lumbar puncture or cervical puncture. © 2018 by American Journal of Neuroradiology.

Transforaminal lumbar interbody fusion versus posterolateral fusion in degenerative lumbar spondylosis: A meta-analysis.

PubMed

Zhang, Bin-Fei; Ge, Chao-Yuan; Zheng, Bo-Long; Hao, Ding-Jun

2016-10-01

The aim of the study was to evaluate the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) versus posterolateral fusion (PLF) in degenerative lumbar spondylosis. A systematic literature review was performed to obtain randomized controlled trials (RCTs) and observational studies (OSs) of TLIF and PLF for degenerative lumbar spondylosis. Trials performed before November 2015 were retrieved from the Medline, EMBASE, Cochrane library, and Chinese databases. Data extraction and quality evaluation of the trials were performed independently by 2 investigators. A meta-analysis was performed using STATA version 12.0. Two RCTs and 5 OSs of 630 patients were included. Of these subjects, 325 were in the TLIF and 305 were in the PLF group. Results showed that TLIF did not increase the fusion rate based on RCTs (relative risk [RR] = 1.06; 95% confidence interval [CI]: 0.95-1.18; P = 0.321), but increased it based on OSs (RR = 1.14; 95% CI: 1.07-1.23; P = 0.000) and overall (RR = 1.11; 95% CI: 1.05-1.18; P = 0.001) as compared with PLF. TLIF was able to improve the clinical outcomes based on 1 RCT (RR = 1.33; 95% CI: 1.11-1.59, P = 0.002) and overall (RR = 1.19; 95% CI: 1.07-1.33; P = 0.001), but not based on OSs (RR = 1.11; 95% CI: 0.97-1.27; P = 0.129) as compared with PLF. There were no differences between TLIF and PLF in terms of visual analogue scale, Oswestry Disability Index, reoperation, complications, duration of surgical procedure, blood loss, and hospitalization. In conclusion, evidence is not sufficient to support that TLIF provides higher fusion rate than PLF, and this poor evidence indicates that TLIF might improve only clinical outcomes. Higher quality, multicenter RCTs are needed to better define the role of TLIF and PLF.

Effect of minimally invasive technique on return to work and narcotic use following transforaminal lumbar inter-body fusion: a review.

PubMed

Parker, Scott L; Lerner, Jason; McGirt, Matthew J

2012-01-01

Low back pain is one of the most prevalent and disabling musculoskeletal conditions affecting the working population in the United States. Informed, shared decision making among patients, clinicians, and case managers about treatment options for chronic low back pain-including the role of spinal fusion where medically necessary-can have a meaningful impact on return to work, normal function, and economic outcomes. Minimally invasive techniques for lumbar spinal fusion, including transforaminal lumbar interbody fusion (MIS TLIF) have recently been introduced with the goal of smaller operative wounds, less tissue trauma, and faster postoperative recovery when compared with open fusion. Although similar long-term clinical outcomes have been reported for MIS TLIF and open TLIF, the relative merits with respect to workplace productivity have not been comprehensively investigated. Time to return to work and narcotic independence after MIS TLIF and open TLIF are important parameters that may affect overall workplace productivity, and as such are the focus of this study. This study was performed via a review of the literature. We performed a systematic literature review to identify all published articles that reported on the postoperative outcomes of patients, as assessed by return to work or narcotic independence status or both, following MIS TLIF or open TLIF. A cumulative comparison was made for all included MIS TLIF versus open TLIF surgeries. Seventy-four published studies reported postoperative outcomes following MIS TLIF or open TLIF; only five (6.8%) studies directly described time to return to work or duration of narcotic use postoperatively or both, and were therefore included into the analysis of this review. Four studies in the published literature describe time to return to work following MIS TLIF or open TLIF, and two studies describe time to narcotic independence. Overall, the reviewed literature suggests that MIS TLIF may be associated with an accelerated

Miniopen Transforaminal Lumbar Interbody Fusion with Unilateral Fixation: A Comparison between Ipsilateral and Contralateral Reherniation

PubMed Central

Liu, Fubing; Jiang, Chun

2016-01-01

The aim of this study was to evaluate the risk factors between ipsilateral and contralateral reherniation and to compare the effectiveness of miniopen transforaminal lumbar interbody fusion (TLIF) with unilateral fixation for each group. From November 2007 to December 2014, clinical and radiographic data of each group (ipsilateral or contralateral reherniation) were collected and compared. Functional assessment (Visual Analog Scale (VAS) score and Japanese Orthopaedic Association (JOA)) and radiographic evaluation (fusion status, disc height, lumbar lordosis (LL), and functional spine unit (FSU) angle) were applied to compare surgical effect for each group preoperatively and at final followup. MacNab questionnaire was applied to further evaluate the satisfactory rate after the discectomy and fusion. No difference except pain-free interval was found between ipsilateral and contralateral groups. There was a significant difference in operative time between two groups. No differences were found in clinical and radiographic data for assessment of surgical effect between two groups. The satisfactory rate was decreasing in both groups with time passing after discectomy. Difference in pain-free interval may be a distinction for ipsilateral and contralateral reherniation. Miniopen TLIF with unilateral pedicle screw fixation can be a recommendable way for single level reherniation regardless of ipsilateral or contralateral reherniation. PMID:27885358

Increased incidence of pseudarthrosis after unilateral instrumented transforaminal lumbar interbody fusion in patients with lumbar spondylosis: Clinical article.

PubMed

Gologorsky, Yakov; Skovrlj, Branko; Steinberger, Jeremy; Moore, Max; Arginteanu, Marc; Moore, Frank; Steinberger, Alfred

2014-10-01

1 patient in the unilateral cohort. Reoperation was offered to 8 patients in the unilateral cohort and 1 patient in the bilateral cohort (p = 0.03). The physical component scores of the Medical Outcomes SF-36 outcomes improved significantly for all patients (p < 0.001). Transforaminal lumbar interbody fusion with either unilateral or bilateral segmental pedicular instrumentation is an effective treatment for lumbar spondylosis. Because patients with unilateral constructs were 7 times more likely to experience pseudarthrosis and require reoperation, TLIF with bilateral constructs might be the biomechanically superior technique.

Comparative Effectiveness and Economic Evaluations of Open Versus Minimally Invasive Posterior or Transforaminal Lumbar Interbody Fusion: A Systematic Review.

PubMed

Goldstein, Christina L; Phillips, Frank M; Rampersaud, Y Raja

2016-04-01

Systematic review of randomized and nonrandomized comparative studies. To summarize the literature examining comparative effectiveness and economic evaluation of minimally invasive versus open transforaminal/posterior lumbar interbody fusion (T/PLIF). Minimally invasive approaches to lumbar fusion have been proposed as an alternative to open surgery to decrease patient morbidity and improve clinical and patient-reported outcomes, with the possibility of secondary cost-savings. The comparative clinical and economic effectiveness of minimally invasive versus open T/PLIF remains largely undetermined. A systematic review of Medline, EMBASE, Web of Science, and Cochrane from database inception to September 2015 inclusive was performed. Reference lists were manually searched. Studies comparing MIS to open T/PLIF for degenerative lumbar conditions, including at least 10 patients in each arm and reporting at least one clinical, perioperative, radiographic, adverse event, or economic outcome, were included. Between database inception and October 2015, 45 studies meeting inclusion criteria were identified with 3472 subjects undergoing MIS fusion and 5925 having an open procedure. There were no significant differences in operative time between the two groups, whereas patients undergoing MIS fusion consistently demonstrated less blood loss (16.1-88.7%) and shorter hospital stays (15.0-64.0% shorter). There was no difference in variably reported VAS, ODI, SF-36, SF-12, or EQ-5D scores between the two techniques at intermediate to long-term follow-up (12-60 months). Complication rates and fusion rates were also equivalent between the two groups. Economic studies demonstrate cost-savings in favor of MIS fusion ranging from 2.5 to 49.3%. Limited quality comparative observational cohort and randomized controlled studies of MIS versus open T/PLIF consistently demonstrate improved perioperative outcomes including operative time, estimated blood loss, and length of stay with no

Application of a narrow-surface cage in full endoscopic minimally invasive transforaminal lumbar interbody fusion.

PubMed

He, Er-Xing; Guo, Jing; Ling, Qin-Jie; Yin, Zhi-Xun; Wang, Ying; Li, Ming

2017-06-01

Spinal endoscopy has been widely applied in lumbar discectomy and decompression. However, endoscopic lumbar interbody fusion still remains a technical challenge due to the limited space within the working trocar for cage implantation. The purpose of this study was to investigate the feasibility and effectiveness of using a narrow-surface fusion cage in full endoscopic minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar degenerative disease. From Jun 2013 to Dec 2014, a total of 42 patients (23 males, 19 females) underwent full endoscopic MIS-TLIF at our hospital was recruited. An 8-mm-wide narrow-surface fusion cage was selected for all cases. Perioperative parameters and complications were recorded. Comparisons on visual analog scale (VAS) and oswestry disability index (ODI) scores before and after surgery were performed. At the last follow-up, Nakai grading system was applied to assess patients' satisfaction; meanwhile, interbody fusion was evaluated by computed tomography. Mean operation time was 233.1 ± 69.5 min, and mean blood loss during surgery was 221.8 ± 98.5 ml. Two patients (4.8%) developed neurological complications. Postoperative follow-up ranged from 24 to 36 months (mean 27.6 ± 3.8 months). VAS and ODI scores were significantly improved 3 months after surgery and at the final follow-up, respectively (P < 0.05). Outcome of surgery was graded as excellent for 32 patients, good for 8 patients, and acceptable for 2 patients, corresponding to a success rate ("good" and "excellent") of 95.2%. Thirty-nine of the 42 patients demonstrated solid interbody fusion at the last follow-up, indicating a fusion rate of 92.9%. Application of a narrow-surface fusion cage in full endoscopic MIS-TLIF for the treatment of lumbar degenerative disease is feasible and effective. The clinical outcome and fusion success of this procedure were acceptable and promising. Copyright © 2017 IJS Publishing Group Ltd

Contralateral radiculopathy after transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: A Case Series.

PubMed

Hu, Hong-Tao; Ren, Liang; Sun, Xian-Ze; Liu, Feng-Yu; Yu, Jin-He; Gu, Zhen-Fang

2018-04-01

Transforaminal lumbar interbody fusion (TLIF) is an effective treatment for patients with degenerative lumbar disc disorder. Contralateral radiculopathy, as a complication of TLIF, has been recognized in this institution, but is rarely reported in the literature. In this article, we report 2 cases of contralateral radiculopathy after TLIF in our institution and its associated complications. In the 2 cases, the postoperative computed tomography (CT) and magnetic resonance image (MRI) showed obvious upward movement of the superior articular process, leading to contralateral foraminal stenosis. Revision surgery was done at once to partially resect the opposite superior facet and to relieve nerve root compression. After revision surgery, the contralateral radiculopathy disappeared. Contralateral radiculopathy is an avoidable potential complication. It is very important to create careful preoperative plans and to conscientiously plan the use of intraoperative techniques. In case of postoperative contralateral leg pain, the patients should be examined by CT and MRI. If CT and MRI show that the superior articular process significantly migrated upwards, which leads to contralateral foraminal stenosis, revision surgery should be done at once to partially resect the contralateral superior facet so as to relieve nerve root compression and avoid possible long-term impairment.

The Influence of Pelvic Incidence and Lumbar Lordosis Mismatch on Development of Symptomatic Adjacent Level Disease Following Single-Level Transforaminal Lumbar Interbody Fusion.

PubMed

Tempel, Zachary J; Gandhoke, Gurpreet S; Bolinger, Bryan D; Khattar, Nicolas K; Parry, Philip V; Chang, Yue-Fang; Okonkwo, David O; Kanter, Adam S

2017-06-01

Annual incidence of symptomatic adjacent level disease (ALD) following lumbar fusion surgery ranges from 0.6% to 3.9% per year. Sagittal malalignment may contribute to the development of ALD. To describe the relationship between pelvic incidence-lumbar lordosis (PI-LL) mismatch and the development of symptomatic ALD requiring revision surgery following single-level transforaminal lumbar interbody fusion for degenerative lumbar spondylosis and/or low-grade spondylolisthesis. All patients who underwent a single-level transforaminal lumbar interbody fusion at either L4/5 or L5/S1 between July 2006 and December 2012 were analyzed for pre- and postoperative spinopelvic parameters. Using univariate and logistic regression analysis, we compared the spinopelvic parameters of those patients who required revision surgery against those patients who did not develop symptomatic ALD. We calculated the predictive value of PI-LL mismatch. One hundred fifty-nine patients met the inclusion criteria. The results noted that, for a 1° increase in PI-LL mismatch (preop and postop), the odds of developing ALD requiring surgery increased by 1.3 and 1.4 fold, respectively, which were statistically significant increases. Based on our analysis, a PI-LL mismatch of >11° had a positive predictive value of 75% for the development of symptomatic ALD requiring revision surgery. A high PI-LL mismatch is strongly associated with the development of symptomatic ALD requiring revision lumbar spine surgery. The development of ALD may represent a global disease process as opposed to a focal condition. Spine surgeons may wish to consider assessment of spinopelvic parameters in the evaluation of degenerative lumbar spine pathology. Copyright © 2017 by the Congress of Neurological Surgeons

[COMPARISON OF EFFECTIVENESS AND CHANGE OF SAGITTAL SPINO-PELVIC PARAMETERS BETWEEN MINIMALLY INVASIVE TRANSFORAMINAL AND CONVENTIONAL OPEN POSTERIOR LUMBAR INTERBODY FUSIONS IN TREATMENT OF LOW-DEGREE ISTHMIC LUMBAR SPONDYLOLISTHESIS].

PubMed

Sun, Xin; Zeng, Rong; Li, Guangsheng; Wei, Bo; Hu, Zibing; Lin, Hao; Chen, Guanghua; Chen, Siyuan; Sun, Jiecong

2015-12-01

To compare the effectiveness and changes of sagittal spino-pelvic parameters between minimally invasive transforaminal lumbar interbody fusion and conventional open posterior lumbar interbody fusion in treatment of the low-degree isthmic lumbar spondylolisthesis. Between May 2012 and May 2013, 86 patients with single segmental isthmic lumbar spondylolisthesis (Meyerding degree I or II) were treated by minimally invasive transforaminal lumbar interbody fusion (minimally invasive group) in 39 cases, and by open posterior lumbar interbody fusion in 47 cases (open group). There was no significant difference in gender, age, disease duration, degree of lumbar spondylolisthesis, preoperative visual analogue scale (VAS) score, and Oswestry disability index (ODI) between 2 groups (P>0.05). The following sagittal spino-pelvic parameters were compared between 2 groups before and after operation: the percentage of slipping (PS), intervertebral height, angle of slip (AS), thoracolumbar junction (TLJ), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), spino-sacral angle (SSA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI). Pearson correlation analysis of the changes between pre- and post-operation was done. Primary healing of incision was obtained in all patients of 2 groups. The postoperative hospital stay of minimally invasive group [(5.1 ± 1.6) days] was significantly shorter than that of open group [(7.2 ± 2.1) days] (t = 2.593, P = 0.017). The patients were followed up 11-20 months (mean, 15 months). The reduction rate was 68.53% ± 20.52% in minimally invasive group, and was 64.21% ± 30.21% in open group, showing no significant difference (t = 0.725, P = 0.093). The back and leg pain VAS scores, and ODI at 3 months after operation were significantly reduced when compared with preoperative ones (P < 0.05), but no significant difference was found between 2 groups (P > 0.05). The postoperative other sagittal spino

[Treatment of lumbar intervertebral disc herniation and sciatica with percutaneous transforaminal endoscopic technique].

PubMed

Jiang, Yi; Song, Hua-Wei; Wang, Dong; Yang, Ming-Lian

2013-10-01

To analyze the clinical effects of percutaneous transforaminal endoscopic technique in treating lumbar intervertebral disc herniation and sciatica. From June 2011 to January 2012,the clinical data of 46 patients with lumbar intervertebral disc herniation and sciatica underwent percutaneous transforaminal endoscopic technique were retrospectively analyzed. There were 28 males and 18 females,ranging in age from 11 to 77 years old with an average of (39.7_ 15.3) years old,20 cases were L5S1 and 26 cases were L4,5. All patients had the symptoms such as lumbago and sciatica and their straight-leg raising test were positive. Straight-leg raising test of patients were instantly repeated after operation;operative time,volume of blood loss,complication, length of stay and duration of back to work or daily life were recorded. The clinical effects were assessed according to the VAS,JOA and JOABPEQ score. All operations were successful,postoperative straight-leg raising test were all negative. Operative time,volume of blood loss,length of stay,duration of back to work or daily life,follow-up time were (93.0+/-28.0) min, (20.0+/-9.0)ml, (3.1+/-1.5) d, (11.6+/-4.2) d, (13.9+/-1.6) months,respectively. VAS score of lumbar before operation and at the 1st and 3rd,6th,12th month after operation were 5.3+/-1.2,1.9+/-1.1,1.0+/-0.8,0.9+/-0.8,0.8+/-0.6,respectively;VAS score of leg before operation and at the 1st and 3rd,6th,12th month after operation were 7.2+ 1.2,0.8+/-1.2,0.5+/-0.8,0.5+/-0.8,0.3+/-0.8,respectively. Five factors of JOABPEQ score,including lumbar pain,lumbar function, locomotor activity,social life viability and mental status,were respectively 27.0+/-30.6,37.3+/-27.4,38.5+/-26.6,33.0+/-13.7,55.4+/-19.0 before operation and 83.6+/-24.8,89.4+/-15.7,87.0+/-17.9,58.4+/-14.6,79.5+/-13.4 at final follow-up. Preoperative and postoperative JOA score were 9.1+/-2.6 and 27.3+/- 1.7, respectively. The postoperative VAS,JOA and JOABPEQ score had significantly improved (P<0

Clinical and radiographic assessment of transforaminal lumbar interbody fusion using HEALOS collagen-hydroxyapatite sponge with autologous bone marrow aspirate.

PubMed

Carter, Jason D; Swearingen, Alan B; Chaput, Christopher D; Rahm, Mark D

2009-06-01

Studies have suggested that the use of bone marrow aspirate (BMA) with HEALOS (DePuy Spine, Raynham, MA), a collagen-hydroxyapatite sponge (CHS), is an effective substitute for autologous iliac crest bone graft when used in fusion procedures of the lumbar spine. To assess clinical and radiographic outcomes after implantation of BMA/CHS in patients undergoing transforaminal lumbar interbody fusion (TLIF) with posterolateral fusion (PLF). Case series radiographic outcome study. Twenty patients. Radiographs/computed tomography (CT) scans. From September 2003 to October 2004, 20 patients (22 interbody levels) were implanted with BMA/CHS via TLIF/PLF with interbody cages and posterior pedicle screws. All patients were retrospectively identified and invited for a 2-year prospective follow-up. Plain radiographs with dynamic films and CT scans were taken, and fusion was assessed in a blinded manner. Follow-up averaged 27 months (range: 24-29). Primary diagnosis included spondylolisthesis (17 patients), scoliosis with asymmetric collapse (2 patients), and postdiscectomy foraminal stenosis (1 patient). The overall fusion rate was 95% (21/22 levels, 19/20 patients). Anteriorly bridging bone was observed in 91% of the anteriorly fused levels (20/22), of which 65% (13/20) occurred through and around the cage and 35% (7/20) around the cage only. Unilateral or bilateral bridging of the posterior fusion masses was observed in 91% (20/22), with 55% occurring bilaterally (12/22). In 4 (18%) cases, bridging only occurred either posteriorly (2 cases) or anteriorly (2 cases). Complications included one deep wound infection. At the 2-year follow-up, BMA/CHS showed acceptable fusion rates in patients undergoing TLIF/PLF, and can be considered as an alternative source of graft material.

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

Application of Gelatin Sponge Impregnated with a Mixture of 3 Drugs to Intraoperative Nerve Root Block Combined with Robot-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery in the Treatment of Adult Degenerative Scoliosis: A Clinical Observation Including 96 Patients.

PubMed

Du, Jin Peng; Fan, Yong; Liu, Ji Jun; Zhang, Jia Nan; Chang Liu, Shi; Hao, Dingjun

2017-12-01

Application of nerve root block is mainly for diagnosis with less application in intraoperative treatment. The aim of this study was to observe clinical and imaging outcomes of application of gelatin sponge impregnated with a mixture of 3 drugs to intraoperative nerve root block combined with robot-assisted minimally invasive transforaminal lumbar interbody fusion surgery in to treat adult degenerative lumbar scoliosis. From January 2012 to November 2014, 108 patients with adult degenerative lumbar scoliosis were treated with robot-assisted minimally invasive transforaminal lumbar interbody fusion surgery combined with intraoperative gelatin sponge impregnated with a mixture of 3 drugs. Visual analog scale and Oswestry Disability Index scores were used to evaluate postoperative improvement of back and leg pain, and clinical effects were assessed according to the 36-Item Short-Form Health Survey. Imaging was obtained preoperatively, 1 week and 3 months postoperatively, and at the last follow-up. Fusion status, complications, and other outcomes were assessed. Follow-up was complete for 96 patients. Visual analog scale scores of leg and back pain on postoperative days 1-7 were decreased compared with preoperatively. At 1 week postoperatively, 3 months postoperatively, and last follow-up, visual analog scale score, Oswestry Disability Index score, coronal Cobb angle, and coronal and sagittal deviated distance decreased significantly (P = 0.000) and lumbar lordosis angle increased (P = 0.000) compared with preoperatively. Improvement rate of Oswestry Disability Index was 81.8% ± 7.4. Fusion rate between vertebral bodies was 92.7%. Application of gelatin sponge impregnated with 3 drugs combined with robot-assisted minimally invasive transforaminal lumbar interbody fusion for treatment of adult degenerative lumbar scoliosis is safe and feasible with advantages of good short-term analgesia effect, minimal invasiveness, short length of stay, and good long-term clinical

An Outcome and Cost Analysis Comparing Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Intraoperative Fluoroscopy versus Computed Tomography-Guided Navigation.

PubMed

Khanna, Ryan; McDevitt, Joseph L; Abecassis, Zachary A; Smith, Zachary A; Koski, Tyler R; Fessler, Richard G; Dahdaleh, Nader S

2016-10-01

Minimally invasive transforaminal lumbar interbody fusion (TLIF) has undergone significant evolution since its conception as a fusion technique to treat lumbar spondylosis. Minimally invasive TLIF is commonly performed using intraoperative two-dimensional fluoroscopic x-rays. However, intraoperative computed tomography (CT)-based navigation during minimally invasive TLIF is gaining popularity for improvements in visualizing anatomy and reducing intraoperative radiation to surgeons and operating room staff. This is the first study to compare clinical outcomes and cost between these 2 imaging techniques during minimally invasive TILF. For comparison, 28 patients who underwent single-level minimally invasive TLIF using fluoroscopy were matched to 28 patients undergoing single-level minimally invasive TLIF using CT navigation based on race, sex, age, smoking status, payer type, and medical comorbidities (Charlson Comorbidity Index). The minimum follow-up time was 6 months. The 2 groups were compared in regard to clinical outcomes and hospital reimbursement from the payer perspective. Average surgery time, anesthesia time, and hospital length of stay were similar for both groups, but average estimated blood loss was lower in the fluoroscopy group compared with the CT navigation group (154 mL vs. 262 mL; P = 0.016). Oswestry Disability Index, back visual analog scale, and leg visual analog scale scores similarly improved in both groups (P > 0.05) at 6-month follow-up. Cost analysis showed that average hospital payments were similar in the fluoroscopy versus the CT navigation groups ($32,347 vs. $32,656; P = 0.925) as well as payments for the operating room (P = 0.868). Single minimally invasive TLIF performed with fluoroscopy versus CT navigation showed similar clinical outcomes and cost at 6 months. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of Lumbar Lordosis on the Adjacent Segment in Transforaminal Lumbar Interbody Fusion: A Finite Element Analysis.

PubMed

Zhao, Xin; Du, Lin; Xie, Youzhuan; Zhao, Jie

2018-06-01

We used a finite element (FE) analysis to investigate the biomechanical changes caused by transforaminal lumbar interbody fusion (TLIF) at the L4-L5 level by lumbar lordosis (LL) degree. A lumbar FE model (L1-S5) was constructed based on computed tomography scans of a 30-year-old healthy male volunteer (pelvic incidence,= 50°; LL, 52°). We investigated the influence of LL on the biomechanical behavior of the lumbar spine after TLIF in L4-L5 fusion models with 57°, 52°, 47°, and 40° LL. The LL was defined as the angle between the superior end plate of L1 and the superior end plate of S1. A 150-N vertical axial preload was imposed on the superior surface of L3. A 10-N/m moment was simultaneously applied on the L3 superior surface along the radial direction to simulate the 4 basic physiologic motions of flexion, extension, lateral bending, and torsion in the numeric simulations. The range of motion (ROM) and intradiscal pressure (IDP) of L3-L4 were evaluated and compared in the simulated cases. In all motion patterns, the ROM and IDP were both increased after TLIF. In addition, the decrease in lordosis generally increased the ROM and IDP in all motion patterns. This FE analysis indicated that decreased spinal lordosis may evoke overstress of the adjacent segment and increase the risk of the pathologic development of adjacent segment degeneration; thus, adjacent segment degeneration should be considered when planning a spinal fusion procedure. Copyright © 2018. Published by Elsevier Inc.

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

RhBMP-2-induced radiculitis in patients undergoing transforaminal lumbar interbody fusion: relationship to dose.

PubMed

Villavicencio, Alan T; Burneikiene, Sigita

2016-10-01

Recombinant human bone morphogenetic protein-2 (rhBMP-2) remains the primary synthetic osteoinductive material used in spinal fusion surgery today. The early inflammation reaction to rhBMP-2 manifesting with radicular symptoms has been previously reported in patients undergoing transforaminal lumbar interbody fusion (TLIF). There is a disagreement with regard to the factors affecting its occurrence and whether such symptoms are dose dependent. The purpose of this analysis was to determine the incidence of rhBMP-2-induced radiculitis and its relationship to dose. A retrospective cohort analysis was performed of the prospectively collected data. All consecutive patients (n=204) who underwent one- or two-level TLIF and instrumented posterolateral fusion with an off-label rhBMP-2 use were included in this analysis. The patients who developed new radicular symptoms after initial improvement postoperatively and had sterile fluid collections indicative of inflammatory process, or in the absence of any structural abnormalities that would explain these symptoms on imaging studies, were deemed to have rhBMP-2-induced radiculitis. Magnetic resonance imaging (MRI) scans were obtained for all patients who developed postoperative radicular symptoms. Correlations between the total rhBMP-2 dose, dose per spinal level, and incidence of radiculitis were evaluated while controlling for age, sex, number of TLIF levels, and surgeon. The incidence of postoperative radiculitis was 11.3% (23 out of 204). The average total rhBMP-2 dose was 4.9 mg (range=2.1-12) and the average dose per spinal level was 3.8 mg (range=1.05-12). Logistic regression analysis did not identify any significant correlations between the rhBMP-2 doses and the incidence of radiculitis (p=.6). The incidence of rhBMP-2-induced radiculitis in patients undergoing TLIF is quite high, but there were no dose-related correlations found. The study, however, cannot rule out a possibility that a larger variation in bone

A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion.

PubMed

Singh, Kern; Nandyala, Sreeharsha V; Marquez-Lara, Alejandro; Fineberg, Steven J; Oglesby, Mathew; Pelton, Miguel A; Andersson, Gunnar B; Isayeva, Darya; Jegier, Briana J; Phillips, Frank M

2014-08-01

Emerging literature suggests superior clinical short- and long-term outcomes of MIS (minimally invasive surgery) TLIFs (transforaminal lumbar interbody fusion) versus open fusions. Few studies to date have analyzed the cost differences between the two techniques and their relationship to acute clinical outcomes. The purpose of the study was to determine the differences in hospitalization costs and payments for patients treated with primary single-level MIS versus open TLIF. The impact of clinical outcomes and their contribution to financial differences was explored as well. This study was a nonrandomized, nonblinded prospective review. Sixty-six consecutive patients undergoing a single-level TLIF (open/MIS) were analyzed (33 open, 33 MIS). Patients in either cohort (MIS/open) were matched based on race, sex, age, smoking status, medical comorbidities (Charlson Comorbidity index), payer, and diagnosis. Every patient in the study had a diagnosis of either degenerative disc disease or spondylolisthesis and stenosis. Operative time (minutes), length of stay (LOS, days), estimated blood loss (EBL, mL), anesthesia time (minutes), Visual Analog Scale (VAS) scores, and hospital cost/payment amount were assessed. The MIS and open TLIF groups were compared based on clinical outcomes measures and hospital cost/payment data using SPSS version 20.0 for statistical analysis. The two groups were compared using bivariate chi-squared analysis. Mann-Whitney tests were used for non-normal distributed data. Effect size estimate was calculated with the Cohen d statistic and the r statistic with a 95% confidence interval. Average surgical time was shorter for the MIS than the open TLIF group (115.8 minutes vs. 186.0 minutes respectively; p=.001). Length of stay was also reduced for the MIS versus the open group (2.3 days vs. 2.9 days, respectively; p=.018). Average anesthesia time and EBL were also lower in the MIS group (p<.001). VAS scores decreased for both groups, although these

Comparison of Clinical and Radiologic Results of Mini-Open Transforaminal Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Indirect Decompression for Degenerative Lumbar Spondylolisthesis

PubMed Central

Gen, Hogaku; Sakuma, Yoshio; Koshika, Yasuhide

2018-01-01

Study Design Retrospective study. Purpose In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis. Overview of Literature There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF. Methods Forty patients who underwent 1-level spinal fusion, either by XLIF indirect decompression (X group, 20 patients) or by mini-open TLIF (T group, 20 patients), for treatment of lumbar degenerative spondylolisthesis were included in this study. Invasiveness of surgery was evaluated on the basis of surgery time, blood loss, hospitalization period, and perioperative complications. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), disc angle (DA), disc height (DH), and slipping length (SL) were evaluated before surgery, immediately after surgery, and at 12 months after surgery. Cross-sectional spinal canal area (CSA) was also measured before surgery and at 1 month after surgery. Results There was no significant difference between the groups in terms of surgery time or hospitalization period; however, X group showed a significant decrease in blood loss (p<0.001). Serious complications were not observed in either group. In clinical assessment, no significant differences were observed between the groups with regard to the JOABPEQ results. The change in DH at 12 months after surgery increased significantly in the X group (p<0.05), and the changes in DA and SL were not significantly different between the two groups. The change in CSA was significantly greater in the T group (p<0.001). Conclusions Postoperative clinical results were equally favorable for both procedures; however, in comparison with mini-open TLIF, less blood loss and greater

Comparison of Clinical and Radiologic Results of Mini-Open Transforaminal Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Indirect Decompression for Degenerative Lumbar Spondylolisthesis.

PubMed

Kono, Yutaka; Gen, Hogaku; Sakuma, Yoshio; Koshika, Yasuhide

2018-04-01

Retrospective study. In this study, we compared the postoperative outcomes of extreme lateral interbody fusion (XLIF) indirect decompression with that of mini-open transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative spondylolisthesis. There are very few reports examining postoperative results of XLIF and minimally invasive TLIF for degenerative lumbar spondylolisthesis, and no reports comparing XLIF and mini-open TLIF. Forty patients who underwent 1-level spinal fusion, either by XLIF indirect decompression (X group, 20 patients) or by mini-open TLIF (T group, 20 patients), for treatment of lumbar degenerative spondylolisthesis were included in this study. Invasiveness of surgery was evaluated on the basis of surgery time, blood loss, hospitalization period, and perioperative complications. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), disc angle (DA), disc height (DH), and slipping length (SL) were evaluated before surgery, immediately after surgery, and at 12 months after surgery. Cross-sectional spinal canal area (CSA) was also measured before surgery and at 1 month after surgery. There was no significant difference between the groups in terms of surgery time or hospitalization period; however, X group showed a significant decrease in blood loss ( p <0.001). Serious complications were not observed in either group. In clinical assessment, no significant differences were observed between the groups with regard to the JOABPEQ results. The change in DH at 12 months after surgery increased significantly in the X group ( p <0.05), and the changes in DA and SL were not significantly different between the two groups. The change in CSA was significantly greater in the T group ( p <0.001). Postoperative clinical results were equally favorable for both procedures; however, in comparison with mini-open TLIF, less blood loss and greater correction of DH were observed in XLIF.

Development of preoperative planning software for transforaminal endoscopic surgery and the guidance for clinical applications.

PubMed

Chen, Xiaojun; Cheng, Jun; Gu, Xin; Sun, Yi; Politis, Constantinus

2016-04-01

Preoperative planning is of great importance for transforaminal endoscopic techniques applied in percutaneous endoscopic lumbar discectomy. In this study, a modular preoperative planning software for transforaminal endoscopic surgery was developed and demonstrated. The path searching method is based on collision detection, and the oriented bounding box was constructed for the anatomical models. Then, image reformatting algorithms were developed for multiplanar reconstruction which provides detailed anatomical information surrounding the virtual planned path. Finally, multithread technique was implemented to realize the steady-state condition of the software. A preoperative planning software for transforaminal endoscopic surgery (TE-Guider) was developed; seven cases of patients with symptomatic lumbar disc herniations were planned preoperatively using TE-Guider. The distances to the midlines and the direction of the optimal paths were exported, and each result was in line with the empirical value. TE-Guider provides an efficient and cost-effective way to search the ideal path and entry point for the puncture. However, more clinical cases will be conducted to demonstrate its feasibility and reliability.

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. Copyright © 2016 Elsevier Ltd. All rights reserved.

Can cantilever transforaminal lumbar interbody fusion (C-TLIF) maintain segmental lordosis for degenerative spondylolisthesis on a long-term basis?

PubMed

Kida, Kazunobu; Tadokoro, Nobuaki; Kumon, Masashi; Ikeuchi, Masahiko; Kawazoe, Tateo; Tani, Toshikazu

2014-03-01

To determine if cantilever transforaminal lumbar interbody fusion (C-TLIF) using the crescent-shaped titanium interbody spacer (IBS) favors acquisition of segmental and lumbar lordosis even for degenerative spondylolisthesis (DS) on a long-term basis. We analyzed 23 consecutive patients who underwent C-TLIF with pedicle screw instrumentations fixed with compression for a single-level DS. Measurements on the lateral radiographs taken preoperatively, 2 weeks postoperatively and at final follow-up included disc angle (DA), segmental angle (SA), lumbar lordosis (LL), disc height (%DH) and slip rate (%slip). There was a good functional recovery with 100 % fusion rate at the mean follow-up of 62 months. Segmental lordosis (DA and SA) and %DH initially increased, but subsequently decreased with the subsidence of the interbody spacer, resulting in a significant increase (p = 0.046) only in SA from 13.2° ± 5.5° preoperatively to 14.7° ± 6.4° at the final follow-up. Changes of LL and %slip were more consistent without correction loss finally showing an increase of LL by 3.6° (p = 0.005) and a slip reduction by 6.7 % (p < 0.001). Despite the inherent limitation of placing the IBS against the anterior endplate of the upper vertebra in the presence of DS, the C-TLIF helped significantly restore segmental as well as lumbar lordosis on a long-term basis, which would be of benefit in preventing hypolordosis-induced back pain and the adjacent level disc disease.

Comparison of complications, costs, and length of stay of three different lumbar interbody fusion techniques: an analysis of the Nationwide Inpatient Sample database.

PubMed

Goz, Vadim; Weinreb, Jeffrey H; Schwab, Frank; Lafage, Virginie; Errico, Thomas J

2014-09-01

Lumbar interbody fusion (LIF) techniques have been used for years to treat a number of pathologies of the lower back. These procedures may use an anterior, posterior, or combined surgical approach. Each approach is associated with a unique set of complications, but the exact prevalence of complications associated with each approach remains unclear. To investigate the rates of perioperative complications of anterior lumbar interbody fusion (ALIF), posterior/transforaminal lumbar interbody fusion (P/TLIF), and LIF with a combined anterior-posterior interbody fusion (APF). Retrospective review of national data from a large administrative database. Patients undergoing ALIF, P/TLIF, or APF. Perioperative complications, length of stay (LOS), total costs, and mortality. The Nationwide Inpatient Sample database was queried for patients undergoing ALIF, P/TLIF, or APF between 2001 and 2010 as identified via International Classification of Diseases, ninth revision codes. Univariate analyses were carried out comparing the three cohorts in terms of the outcomes of interest. Multivariate analysis for primary outcomes was carried out adjusting for overall comorbidity burden, race, gender, age, and length of fusion. National estimates of annual total number of procedures were calculated based on the provided discharge weights. Geographic distribution of the three cohorts was also investigated. An estimated total of 923,038 LIFs were performed between 2001 and 2010 in the United States. Posterior/transforaminal lumbar interbody fusions accounted for 79% to 86% of total LIFs between 2001 and 2010, ALIFs for 10% to 15%, and APF decreased from 10% in 2002 to less than 1% in 2010. On average, P/TLIF patients were oldest (54.55 years), followed by combined approach (47.23 years) and ALIF (46.94 years) patients (p<.0001). Anterior lumbar interbody fusion, P/TLIF, and combined surgical costs were $75,872, $65,894, and $92,249, respectively (p<.0001). Patients in the P/TLIF cohort had the

Postoperative dysesthesia in minimally invasive transforaminal lumbar interbody fusion: a report of five cases.

PubMed

Wang, Honggang; Zhou, Yue; Zhang, Zhengfeng

2016-05-01

Minimally invasive transforaminal lumbar interbody fusion (misTLIF) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in misTLIF. Between January 2010 and December 2014, 539 patients were treated with misTLIF in investigator group. POD was defined as dysesthetic pain or burning dysesthesia at a proper DRG innervated region, whether spontaneous or evoked. Non-steroidal antiinflammatory drugs, central non-opioid analgesic agent, neuropathic pain drugs and/or intervertebral foramen block were selectively used to treat POD. There were five cases of POD (5/539, 0.9 %), which consisted of one patient in recurrent lumbar disc herniation (1/36, 3 %), one patient in far lateral lumbar disc herniation (1/34, 3 %), and 3 patients in lumbar spondylolisthesis (3/201, 1 %). Two DRG injury cases were confirmed by revision surgery. After the treatment by drugs administration plus DRG block, all patients presented pain relief with duration from 22 to 50 days. A gradual pain moving to distal end of a proper DRG innervated region was found as the beginning of end. Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in misTLIF, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovery may be used as a sign for the good prognosis.

Clinical and radiographic outcomes of bilateral decompression via a unilateral approach with transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis with stenosis.

PubMed

Cheng, Xiaofei; Zhang, Kai; Sun, Xiaojiang; Zhao, Changqing; Li, Hua; Ni, Bin; Zhao, Jie

2017-08-01

Laminectomy with posterior lumbar interbody fusion (PLIF) has been shown to achieve satisfactory clinical outcomes, but it leads to potential adverse consequences associated with extensive disruption of posterior bony and soft tissue structures. This study aimed to compare the clinical and radiographic outcomes of bilateral decompression via a unilateral approach (BDUA) with transforaminal lumbar interbody fusion (TLIF) and laminectomy with PLIF in the treatment of degenerative lumbar spondylolisthesis (DLS) with stenosis. This is a prospective cohort study. This study compared 43 patients undergoing BDUA+TLIF and 40 patients undergoing laminectomy+PLIF. Visual analog scale (VAS) for low back pain and leg pain, Oswestry Disability Index (ODI), and Zurich Claudication Questionnaire (ZCQ) score. The clinical outcomes were assessed, and intraoperative data and complications were collected. Radiographic outcomes included slippage of the vertebra, disc space height, segmental lordosis, and final fusion rate. This study was supported by a grant from The National Natural Science Foundation of China (81572168). There were significant improvements in clinical and radiographic outcomes from before surgery to 3 months and 2 years after surgery within each group. Analysis of leg pain VAS and ZCQ scores showed no significant differences in improvement between groups at either follow-up. The mean improvements in low back pain VAS and ODI scores were significantly greater in the BDUA+TLIF group than in the laminectomy+PLIF group. No significant difference was found in the final fusion rate at 2-year follow-up. The BDUA+TLIF group had significantly less blood loss, shorter length of postoperative hospital stay, and lower complication rate compared with the laminectomy+PLIF group. When compared with the conventional laminectomy+PLIF procedure, the BDUA+TLIF procedure achieves similar and satisfactory effects of decompression and fusion for DLS with stenosis. The BDUA+TLIF procedure

Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note.

PubMed

van Velsen, Valery; van Helmond, Noud; Chapman, Kenneth B

2018-04-01

Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio-economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop at the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation at the S1 level using a transforaminal approach that we employed in a 45-year-old patient with intractable foot pain. We successfully placed a strain relief loop in the sacral space in a predictable and easily reproducible manner using a transforaminal anchorless approach. The patient experienced a decrease in visual analog pain score (85%), and improvement in function during the trial period, and proceeded with permanent implantation. The described sacral transforaminal strain relief loop formation technique appears to be a more reliable and predictable technique of DRG lead placement in the sacrum than those previously documented. © 2017 World Institute of Pain.

Comparison of transforaminal lumbar interbody fusion outcomes in patients receiving rhBMP-2 versus autograft.

PubMed

Khan, Taleef R; Pearce, Kalin R; McAnany, Steven J; Peters, Colleen M; Gupta, Munish C; Zebala, Lukas P

2018-03-01

Recombinant human bone morphogenetic protein 2 (rhBMP-2) plays a pivotal role in complex spine surgery. Despite its limited approval, the off-label use of rhBMP-2 is prevalent, particularly in transforaminal lumbar interbody fusions (TLIFs). To determine the effectiveness and safety of rhBMP-2 use in TLIF procedures versus autograft. Retrospective cohort study. Patients older than 18 years undergoing spine surgery for lumbar degenerative spine disease at a single academic institution. Clinical outcome was determined according to patient records. Radiographic outcome was determined according to plain X-rays and computed tomography (CT). A retrospective study from 1997 to 2014 was conducted on 191 adults undergoing anterior-posterior instrumented spinal fusion with TLIF at a single academic institution. Patient data were gathered from operative notes, follow-up clinic notes, and imaging studies to determine complications and fusion rates. One hundred eighty-seven patients fit the criteria, which included patients with a minimum of one TLIF, and had a minimum 2-year radiographic and clinical follow-up. Patients were further classified into a BMP group (n=83) or non-BMP group (n=104). Three logistic regression models were run using rhBMP-2 exposure as the independent variable. The respective outcome variables were TLIF-related complications (radiculitis, seroma, osteolysis, and ectopic bone), surgical complications, and all complications. Bone morphogenetic protein (n=83) and non-BMP (n=104) groups had similar baseline demographics (sex, diabetes, pre-existing cancer). On average, the BMP and non-BMP groups were similarly aged (51.9 vs. 47.9 years, p>.05), but the BMP group had a shorter follow-up time (3.03 vs. 4.06 years; p<.001) and fewer smokers (8 vs. 21 patients; p<.048). The fusion rate for the BMP and non-BMP groups was 92.7% and 92.3%, respectively. The pseudoarthrosis rate was 7.5% (14 of 187 patients). Radiculitis was observed in seven patients in the BMP

Transforaminal Lumbar Interbody Fusion with Rigid Interspinous Process Fixation: A Learning Curve Analysis of a Surgeon Team's First 74 Cases.

PubMed

Doherty, Patrick; Welch, Arthur; Tharpe, Jason; Moore, Camille; Ferry, Chris

2017-05-30

Studies have shown that a significant learning curve may be associated with adopting minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) with bilateral pedicle screw fixation (BPSF). Accordingly, several hybrid TLIF techniques have been proposed as surrogates to the accepted BPSF technique, asserting that less/fewer fixation(s) or less disruptive fixation may decrease the learning curve while still maintaining the minimally disruptive benefits. TLIF with interspinous process fixation (ISPF) is one such surrogate procedure. However, despite perceived ease of adaptability given the favorable proximity of the spinous processes, no evidence exists demonstrating whether or not the technique may possess its own inherent learning curve. The purpose of this study was to determine whether an intraoperative learning curve for one- and two-level TLIF + ISPF may exist for a single lead surgeon. Seventy-four consecutive patients who received one- or two-Level TLIF with rigid ISPF by a single lead surgeon were retrospectively reviewed. It was the first TLIF + ISPF case series for the lead surgeon. Intraoperative blood loss (EBL), hospitalization length-of-stay (LOS), fluoroscopy time, and postoperative complications were collected. EBL, LOS, and fluoroscopy time were modeled as a function of case number using multiple linear regression methods. A change point was included in each model to allow the trajectory of the outcomes to change during the duration of the case series. These change points were determined using profile likelihood methods. Models were fit using the maximum likelihood estimates for the change points. Age, sex, body mass index (BMI), and the number of treated levels were included as covariates. EBL, LOS, and fluoroscopy time did not significantly differ by age, sex, or BMI (p ≥ 0.12). Only EBL differed significantly by the number of levels (p = 0.026). The case number was not a significant predictor of EBL, LOS, or fluoroscopy time (p ≥ 0

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.

Assessment of Paraspinal Muscle Atrophy Percentage after Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Instrumentation Using a Novel Contralateral Intact Muscle-Controlled Model.

PubMed

Ortega-Porcayo, Luis Alberto; Leal-López, Andres; Soriano-López, Miroslava Elizabeth; Gutiérrez-Partida, Carlos Francisco; Ramírez-Barrios, Luis Rodolfo; Soriano-Solis, Sergio; Rodríguez-García, Manuel; Soriano-Solis, Hector Antonio; Soriano-Sánchez, José Antonio

2018-04-01

Retrospective comparative clinical study. This study aimed to assess paraspinal muscle atrophy in patients who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and unilateral pedicle screw fixation using a novel contralateral intact muscle-controlled model. The increased incidence of paravertebral lumbar muscle injuries after open techniques has raised the importance of implementing minimally invasive spine surgical techniques using tubular retractors and minimally invasive screw placement. The functional cross-sectional area (FCSA) represents the lean muscle mass; furthermore, FCSA is a useful marker of the contractile ability of a muscle following a spine surgery. However, the benefits of unilateral fixation and MI-TLIF on paraspinal muscles have not been defined. We performed a retrospective imagenological review on eleven patients who underwent unilateral MI-TLIF and unilateral transpedicular screw lumbar placement. FCSAs of the multifidus and erector spinae were measured 1 year after surgery at adjacent levels and were compared to the contralateral intact muscles. Measurement differences between the surgical and nonsurgical sites were compared. The interobserver reliability was calculated using an intraclass correlation coefficient. The mean FCSA at the surgical site was 20.97±5.07 cm 2 at the superior level and 8.89±2.87 cm 2 at the inferior level. The mean FCSA at the contralateral nonsurgical site was 20.15±5.95 cm 2 at the superior level and 9.20±2.66 cm 2 at the inferior level was. The superior and inferior FCSA measurements showed no significant difference between the surgical and nonsurgical sites ( p =0.5, p =0.922, respectively). Using a mini-open tubular approach through the sulcus between the longissimus and iliocostalis, MI-TLIF and unilateral pedicle screw instrumentation produced minimal paraspinal muscle damage at the superior and inferior adjacent levels.

Assessment of Paraspinal Muscle Atrophy Percentage after Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Instrumentation Using a Novel Contralateral Intact Muscle-Controlled Model

PubMed Central

Ortega-Porcayo, Luis Alberto; Leal-López, Andres; Soriano-López, Miroslava Elizabeth; Gutiérrez-Partida, Carlos Francisco; Ramírez-Barrios, Luis Rodolfo; Soriano-Solis, Sergio; Rodríguez-García, Manuel; Soriano-Solis, Hector Antonio

2018-01-01

Study Design Retrospective comparative clinical study. Purpose This study aimed to assess paraspinal muscle atrophy in patients who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and unilateral pedicle screw fixation using a novel contralateral intact muscle-controlled model. Overview of Literature The increased incidence of paravertebral lumbar muscle injuries after open techniques has raised the importance of implementing minimally invasive spine surgical techniques using tubular retractors and minimally invasive screw placement. The functional cross-sectional area (FCSA) represents the lean muscle mass; furthermore, FCSA is a useful marker of the contractile ability of a muscle following a spine surgery. However, the benefits of unilateral fixation and MI-TLIF on paraspinal muscles have not been defined. Methods We performed a retrospective imagenological review on eleven patients who underwent unilateral MI-TLIF and unilateral transpedicular screw lumbar placement. FCSAs of the multifidus and erector spinae were measured 1 year after surgery at adjacent levels and were compared to the contralateral intact muscles. Measurement differences between the surgical and nonsurgical sites were compared. The interobserver reliability was calculated using an intraclass correlation coefficient. Results The mean FCSA at the surgical site was 20.97±5.07 cm2 at the superior level and 8.89±2.87 cm2 at the inferior level. The mean FCSA at the contralateral nonsurgical site was 20.15±5.95 cm2 at the superior level and 9.20±2.66 cm2 at the inferior level was. The superior and inferior FCSA measurements showed no significant difference between the surgical and nonsurgical sites (p=0.5, p=0.922, respectively). Conclusions Using a mini-open tubular approach through the sulcus between the longissimus and iliocostalis, MI-TLIF and unilateral pedicle screw instrumentation produced minimal paraspinal muscle damage at the superior and inferior adjacent

A practical laboratory study simulating the percutaneous lumbar transforaminal epidural injection: training model in fresh cadaveric sheep spine.

PubMed

Suslu, Husnu

2012-01-01

Laboratory training models are essential for developing and refining treatment skills before the clinical application of surgical and invasive procedures. A simple simulation model is needed for young trainees to learn how to handle instruments, and to perform safe lumbar transforaminal epidural injections. Our aim is to present a model of a fresh cadaveric sheep lumbar spine that simulates the lumbar transforaminal epidural injection. The material consists of a 2-year-old fresh cadaveric sheep spine. A 4-step approach was designed for lumbar transforaminal epidural injection under C-arm scopy. For the lumbar transforaminal epidural injection, the fluoroscope was adjusted to get a proper oblique view while the material was stabilized in a prone position. The procedure then begin, using the C-arm guidance scopy. The model simulates well the steps of standard lumbar transforaminal epidural injections in the human spine. The cadaveric sheep spine represents a good method for training and it simulates fluoroscopic lumbar transforaminal epidural steroid injection procedures performed in the human spine.

The Role of Posterior Screw Fixation in Single-Level Transforaminal Lumbar Interbody Fusion During Whole Body Vibration: A Finite Element Study.

PubMed

Fan, Wei; Guo, Li-Xin

2018-06-01

Few studies have evaluated the need for supplementary instrumentation after lumbar interbody fusion under the condition of whole body vibration (WBV) that is typically present in vehicles. This study aimed to determine the effect of posterior pedicle screw fixation on dynamic response of the whole lumbar spine to vertical WBV after transforaminal lumbar interbody fusion (TLIF). A previously validated nonlinear, osteoligamentous finite element (FE) model of the intact L1-sacrum human lumbar spine was modified to simulate single-level (L4-L5) TLIF without and with bilateral pedicle screw fixation (BPSF). Transit dynamic analysis was performed on the 2 developed models under a sinusoidal vertical vibration load of ±40 N and a compressive follower preload of 400 N. The resulting dynamic response results for the 2 models in terms of stresses and deformations were recorded and compared. When compared with no fixation, BPSF decreased dynamic responses of the spinal levels to the vertical vibration after TLIF. At the fused level (L4-L5), vibration amplitudes of the von-Mises stresses in L4 inferior endplate and L5 superior endplate decreased after BPSF by 48.0% and 46.4%, respectively. At other disc levels (L1-L2, L2-L3, L3-L4, and L5-S1), vibration amplitudes of the disc bulge, von-Mises stress in annulus ground substance and intradiscal pressure also produced 4.2%-9.0%, 2.3%-8.9%, and 3.4%-8.8% deceases, respectively, after BPSF. After TLIF, application of BPSF can be helpful in the prevention of spine injury during vertical WBV. Copyright © 2018 Elsevier Inc. All rights reserved.

[A feasibility research of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation for recurrent lumbar disc herniation].

PubMed

Mao, Ke-ya; Wang, Yan; Xiao, Song-hua; Zhang, Yong-gang; Liu, Bao-wei; Wang, Zheng; Zhang, Xi-Feng; Cui, Geng; Zhang, Xue-song; Li, Peng; Mao, Ke-zheng

2013-08-01

To investigate the feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation of pedicle screws and a translaminar facet screw for recurrent lumbar disc herniation. From January 2010 to December 2011, 16 recurrent lumbar disc herniation patients, 10 male and 6 female patients with an average age of 45 years (35-68 years) were treated with unilateral incision MIS-TLIF through working channel. After decompression, interbody fusion and fixation using unilateral pedicle screws, a translaminar facet screw was inserted from the same incision through spinous process and laminar to the other side facet joint. The results of perioperative parameters, radiographic images and clinical outcomes were assessed. The repeated measure analysis of variance was applied in the scores of visual analogue scale (VAS) and Oswestry disablity index (ODI). All patients MIS-TLIF were accomplished under working channel including decompression, interbody fusion and hybrid fixation without any neural complication. The average operative time was (148 ± 75) minutes, the average operative blood loss was (186 ± 226) ml, the average postoperative ambulation time was (32 ± 15) hours, and the average hospitalization time was (6 ± 4) days. The average length of incision was (29 ± 4) mm, and the average length of translaminar facets screw was (52 ± 6) mm. The mean follow-up was 16.5 months with a range of 12-24 months. The postoperative X-ray and CT images showed good position of the hybrid internal fixation, and all facets screws penetrate through facets joint. The significant improvement could be found in back pain VAS, leg pain VAS and ODI scores between preoperative 1 day and postoperative follow-up at all time-points (back pain VAS:F = 52.845, P = 0.000;leg pain VAS:F = 113.480, P = 0.000;ODI:F = 36.665, P = 0.000). Recurrent lumbar disc herniation could be treated with MIS-TLIF using hybrid fixation through unilateral incision, and the

One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series.

PubMed

Zhang, Hong-qi; Lin, Min-zhong; Li, Jin-song; Tang, Ming-xing; Guo, Chao-feng; Wu, Jian-huang; Liu, Jin-yang

2013-03-01

The purpose of this study is to compare the clinical outcomes of surgical management by one-stage posterior debridement, transforaminal lumbar interbody fusion (TLIF) and instrumentation and combined posterior and anterior approaches for lumbar spinal tuberculosis, and determine the clinical effectiveness of the posterior only surgical treatment for lumbar spinal TB at the same time. Thirty-seven patients who suffered lumbar tuberculosis were treated by two different surgical procedures in our center from May 2004 to June 2012. All the cases were divided into two groups: 19 cases in Group A underwent one-stage posterior debridement, TLIF and instrumentation, and 18 cases in Group B underwent posterior instrumentation, anterior debridement and bone graft in a single-stage procedure. The operation time, blood loss, lumbar kyphotic angle, recovery of neurological function and fusion time were, respectively, compared between Group A and Group B. The average follow-up period for Group A was 46.6 ± 16.7 months, and for Group B, 47.5 ± 15.0 months. It was obvious that the average operative duration and blood loss of Group A was less than those of Group B. Lumbar tuberculosis was completely cured and the grafted bones were fused in 10 months in all patients. There was no persistence or recurrence of infection and no differences in the radiological results in both groups. The kyphosis was significantly corrected after surgical management. The average pretreatment ESR was 60.7 ± 22.5 mm/h, which became normal (9.0 ± 2.8 mm/h) within 3 months in all patients. Surgical management by one-stage posterior debridement, TLIF and instrumentation for lumbar tuberculosis is feasible and effective. This approach obtained better clinical outcomes than combined posterior and anterior surgeries.

Comparison of two-transsacral-screw fixation versus triangular osteosynthesis for transforaminal sacral fractures.

PubMed

Min, Kyong S; Zamorano, David P; Wahba, George M; Garcia, Ivan; Bhatia, Nitin; Lee, Thay Q

2014-09-01

Transforaminal pelvic fractures are high-energy injuries that are translationally and rotationally unstable. This study compared the biomechanical stability of triangular osteosynthesis vs 2-transsacral-screw fixation in the repair of a transforaminal pelvic fracture model. A transforaminal fracture model was created in 10 cadaveric lumbopelvic specimens. Five of the specimens were stabilized with triangular osteosynthesis, which consisted of unilateral L5-to-ilium lumbopelvic fixation and ipsilateral iliosacral screw fixation. The remaining 5 were stabilized with a 2-transsacral-screw fixation technique that consisted of 2 transsacral screws inserted across S1. All specimens were loaded cyclically and then loaded to failure. Translation and rotation were measured using the MicroScribe 3D digitizing system (Revware Inc, Raleigh, North Carolina). The 2-transsacral-screw group showed significantly greater stiffness than the triangular osteosynthesis group (2-transsacral-screw group, 248.7 N/mm [standard deviation, 73.9]; triangular osteosynthesis group, 125.0 N/mm [standard deviation, 66.9]; P=.02); however, ultimate load and rotational stiffness were not statistically significant. Compared with triangular osteosynthesis fixation, the use of 2 transsacral screws provides a comparable biomechanical stability profile in both translation and rotation. This newly revised 2-transsacral-screw construct offers the traumatologist an alternative method of repair for vertical shear fractures that provides biplanar stability. It also offers the advantage of percutaneous placement in either the prone or supine position. Copyright 2014, SLACK Incorporated.

An awake, minimally-invasive, fully-endoscopic surgical technique for treating lumbar radiculopathy secondary to heterotopic foraminal bone formation after a minimally invasive transforaminal lumbar interbody fusion with BMP: technical note

PubMed Central

2018-01-01

One complication associated with recombinant human bone morphogenetic protein (rhBMP-2) use in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is heterotopic bone growth at the neural foramen which results in the compression of neural structures. Here we present an awake, minimally invasive surgical approach for treating the radiculopathy that results from this excessive bone growth in the foramen. A 42-year-old male underwent a lumbar 4–sacral 1 MIS-TLIF by another surgeon. He did well in the initial postoperative period, but he began to note right leg pain and numbness in an L5 dermatomal pattern. The pain continued for 2 years despite interventional pain management, and he began to note left foot dorsiflexion weakness. An electromyography (EMG) showed a left L5 radiculopathy and a CT Lumbar spine demonstrated excessive bone growth in the right L4–5 neural foramen. The patient underwent an awake, endoscopic foraminotomy procedure utilizing a blunt tipped manual shaver drill system. The patient’s radicular symptoms improved immediately, and he remained asymptomatic at the 1 year follow up. Heterotopic foraminal bone growth is one potential complication of rhBMP-2 use in the MIS-TLIF procedure. The endoscopic procedure described here is a minimally invasive surgical option that can be performed in an awake patient and is suggested a unique salvage or rescue procedure to be considered for the treatment of this potential rhBMP-2 complication. PMID:29732437

Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique.

PubMed

Cho, J Y; Lee, S-H; Lee, H-Y

2011-10-01

Transforaminal percutaneous endoscopic lumbar discectomy (PELD) has become a routine surgical procedure because it is minimally invasive. Perioperative complications such as dural injury, infection, nerve root irritation and recurrence can occur not only with PELD, but also with conventional open microsurgery. In contrast, post-operative dysesthesia (POD) due to existing dorsal root ganglion (DRG) injury is a unique complication of PELD. When POD occurs, even if the traversing root has been successfully decompressed, it hinders swift recovery and delays the return to daily routines. Thus, prevention of POD is the key to successful and widespread use of PELD. From January 2006 to December 2008, 154 patients underwent percutaneous endoscopic discectomy by floating retraction technique at 160 disc levels under local anesthesia. This approach towards the superomedial border of the lower pedicle and the cannula can be placed by gentle retraction of the root with perineural fat instead of direct compression of dorsal root ganglion. The clinical outcomes were assessed using the Visual Analogue Scale (VAS, 0-10 point) for radicular pain and low back pain, and using the Oswestry Disability Index (ODI) for functional status. Perioperative complications and recurrence were reviewed. The mean age was 45 years, the mean operative time was 36 min and the mean follow-up period was 3.4 years. The mean hospital stay for endoscopic discectomy was 1.8 days. No patient underwent repeated PELD or convert microsurgery by incomplete removal of the ruptured particle. All patients experienced early relief of symptoms, as determined by VAS and ODI. No patient developed POD. 1 patient experienced dural injury. There was 1 case of discitis. The recurrence rate was 1.95% (3 patients). Transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation is a safe and effective procedure. The floating retraction technique is recommended to avoid development of

Evaluation of lumbar transforaminal epidural injections with needle placement and contrast flow patterns: a prospective, descriptive report.

PubMed

Manchikanti, Laxmaiah; Cash, Kim A; Pampati, Vidyasagar; Damron, Kim S; McManus, Carla D

2004-04-01

Transforaminal epidural steroid injection is one of the commonly employed modalities of treatment in managing nerve root pain. However, there have been no controlled prospective evaluations of epidural and nerve root contrast distribution patterns and other aspects of fluoroscopically directed lumbosacral transforaminal epidural steroid injections. To evaluate contrast flow patterns and intravascular needle placement of fluoroscopically guided lumbosacral transforaminal epidural injections. A prospective, observational study. A total of 100 consecutive patients undergoing fluoroscopically guided transforaminal epidural steroid injections were evaluated. The contrast flow patterns, ventral or dorsal epidural filling, nerve root filling, C-arm time, and intravascular needle placement were evaluated. Ventral epidural filling was seen in 88% of the procedures, in contrast to dorsal filling noted in 9% of the procedures. Nerve root filling was seen in 97% of the procedures. Total intravenous placement of the needle was noted in 22% of the procedures, whereas negative flashback and aspiration was noted in 5% of the procedures. Lumbosacral transforaminal epidural injections, performed under fluoroscopic visualization, provide excellent nerve root filling and ventral epidural filling patterns. However, unrecognized intravascular needle placement with negative flashback or aspiration was noted in 5% of the procedures.

Radiographic Appearance of Transforaminal Lumbar Interbody Fusion Performed With and Without Recombinant Human Morphogenetic Protein-2.

PubMed

Stensby, J Derek; Kaliney, Ryan W; Alford, Bennett; Shen, Francis H; Patrie, James T; Fox, Michael G

2016-03-01

The purpose of this study is to determine whether recombinant human morphogenetic protein-2 (rhBMP-2) alters the findings on routine radiographs performed after transforaminal lumbar interbody fusion (TLIF). A retrospective review of 256 TLIF procedures in 200 patients was performed over a 4-year period. The rhBMP-2 group included 204 TLIFs in 160 patients, and the control group included 52 TLIFs in 40 patients. Two musculoskeletal radiologists reviewed the postoperative radiographs for endplate resorption, resorption resolution, new bone formation, bridging bone, and allograft migration. Statistical analysis was performed using logistic regression. The median age was 53 years in the rhBMP-2 group and 54 years in the control group (p = 0.182). The groups were similar with regard to sex (p = 0.517), single or multilevel TLIF (p = 0.921), specific TLIF levels (p = 0.53), and median radiographic follow-up (373 vs 366 days; p = 0.34). Findings that were more common in the rhBMP-2 group than in the control group included endplate resorption (38% [78/204] vs 12% [6/52]; odds ratio [OR], 4.67; 95% CI, 1.99-12.54; p < 0.001), resorption resolution (59% [46/78] vs 0% [0/6]; OR, 8.09; 95% CI, 1.41 to ∞; p = 0.022), new bone formation (84% [171/204] vs 67% [35/52]; OR, 2.51; 95% CI, 1.24-4.99; p = 0.011), bridging bone (55% [112/204] vs 31% [16/52]; OR, 2.73; 95% CI, 1.43-5.34; p = 0.002), and allograft migration (17% [35/204] vs 2% [1/52]; OR, 6.30; 95% CI, 0.91-151.41; p = 0.065). A statistically significant higher frequency of endplate resorption, new bone formation, and bone bridging is present in TLIF augmented by rhBMP-2 compared with TLIF performed without rhBMP-2. Endplate resorption resolves without treatment in most cases after rhBMP-2 use.

Does Day of Surgery Affect Hospital Length of Stay and Charges Following Minimally Invasive Transforaminal Lumbar Interbody Fusion?

PubMed

Hijji, Fady Y; Narain, Ankur S; Haws, Brittany E; Khechen, Benjamin; Kudaravalli, Krishna T; Yom, Kelly H; Singh, Kern

2018-06-01

Retrospective Cohort. To determine if an association exists between surgery day and length of stay or hospital costs after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Length of inpatient stay after orthopedic procedures has been identified as a primary cost driver, and previous research has focused on determining risk factors for prolonged length of stay. In the arthroplasty literature, surgery performed later in the week has been identified as a predictor of increased length of stay. However, no such investigation has been performed for MIS TLIF. A surgical registry of patients undergoing MIS TLIF between 2008 and 2016 was retrospectively reviewed. Patients were grouped based on day of surgery, with groups including early surgery and late surgery. Day of surgery group was tested for an association with demographics and perioperative variables using the student t test or χ analysis. Day of surgery group was then tested for an association with direct hospital costs using multivariate linear regression. In total, 438 patients were analyzed. In total, 51.8% were in the early surgery group, and 48.2% were in the late surgery group. There were no differences in demographics between groups. There were no differences between groups with regard to operative time, intraoperative blood loss, length of stay, or discharge day. Finally, there were no differences in total hospital charges between early and late surgery groups (P=0.247). The specific day on which a MIS TLIF procedure occurs is not associated with differences in length of inpatient stay or total hospital costs. This suggests that the postoperative course after MIS TLIF procedures is not affected by the differences in hospital staffing that occurs on the weekend compared with weekdays.

Perioperative surgical complications and learning curve associated with minimally invasive transforaminal lumbar interbody fusion: a single-institute experience.

PubMed

Park, Yung; Lee, Soo Bin; Seok, Sang Ok; Jo, Byung Woo; Ha, Joong Won

2015-03-01

As surgical complications tend to occur more frequently in the beginning stages of a surgeon's career, knowledge of perioperative complications is important to perform a safe procedure, especially if the surgeon is a novice. We sought to identify and describe perioperative complications and their management in connection with minimally invasive transforaminal lumbar interbody fusion (TLIF). We performed a retrospective chart review of our first 124 patients who underwent minimally invasive TLIF. The primary outcome measure was adverse events during the perioperative period, including neurovascular injury, implant-related complications, and wound infection. Pseudarthroses and adjacent segment pathologies were not included in this review. Adverse events that were not specifically related to spinal surgery and did not affect recovery were also excluded. Perioperative complications occurred in 9% of patients (11/124); including three cases of temporary postoperative neuralgia, two deep wound infections, two pedicle screw misplacements, two cage migrations, one dural tear, and one grafted bone extrusion. No neurologic deficits were reported. Eight complications occurred in the first one-third of the series and only 3 complications occurred in the last two-thirds of the series. Additional surgeries were performed in 6% of patients (7/124); including four reoperations (two for cage migrations, one for a misplaced screw, and one for an extruded graft bone fragment) and three hardware removals (one for a misplaced screw and two for infected cages). We found perioperative complications occurred more often in the early period of a surgeon's experience with minimally invasive TLIF. Implant-related complications were common and successfully managed by additional surgeries in this series. We suggest greater caution should be exercised to avoid the potential complications, especially when surgeon is a novice to this procedure.

Risk factor of contralateral radiculopathy following microendoscopy-assisted minimally invasive transforaminal lumbar interbody fusion.

PubMed

Yang, Yang; Liu, Zhong-Yu; Zhang, Liang-Ming; Dong, Jian-Wen; Xie, Pei-Gen; Chen, Rui-Qiang; Yang, Bu; Liu, Chang; Liu, Bin; Rong, Li-Min

2017-12-08

Microendoscopy-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is an advantageous method for treating lumbar degenerative disease; however, some patients show contralateral radiculopathy postoperatively. This study aims to investigate its risk factor. A total of 130 cases who underwent microendoscopy-assisted MIS-TLIF at L4-5 level were divided into symptomatic and asymptomatic groups according to the presence of postoperative contralateral radiculopathy. Both preoperative and postoperative radiographic parameters, as well as their changes were compared between the two groups, including lumbar lordosis (LL), surgical segmental angle (SSA), disc height (DH), contralateral foramen area (CFA) and contralateral canal area (CCA). Screw breach on contralateral L4 pedicle and decompression method (ipsilateral or bilateral canal decompression through unilateral route) were also analyzed as potential risk factors. Receiver operating characteristic (ROC) curve was drawn for the risk factor to determine the optimal threshold for predicting postoperative contralateral radiculopathy. Besides, clinical outcome assessment, involving Visual Analog Score (VAS) for back and leg, Japanese Orthopaedics Association Score (JOA) and Oswestry Disability Index (ODI), was also compared between the two groups before surgery and at final follow-up (at least 3 months after the surgery for asymptomatic patients or final treatments of contralateral radiculopathy for symptomatic cases). Postoperative contralateral radiculopathy occurred in 11 (8.5%) of the 130 patients. Both preoperative and postoperative CFA as well as its change were significantly decreased in symptomatic group compared with asymptomatic group (all P < 0.05). For the remaining four parameters (LL, SSA, DH, CCA), their preoperative, postoperative and change values showed no statistical difference between the two groups (all P > 0.05). Neither screw breach nor decompression method revealed

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

PubMed

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

2015-11-25

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 AND 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.

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

Do intraoperative radiographs predict final lumbar sagittal alignment following single-level transforaminal lumbar interbody fusion?

PubMed

Salem, Khalid M I; Eranki, Aditya P; Paquette, Scott; Boyd, Michael; Street, John; Kwon, Brian K; Fisher, Charles G; Dvorak, Marcel F

2018-05-01

OBJECTIVE The study aimed to determine if the intraoperative segmental lordosis (as calculated on a cross-table lateral radiograph following a single-level transforaminal lumbar interbody fusion [TLIF] for degenerative spondylolisthesis/low-grade isthmic spondylolisthesis) is maintained at discharge and at 6 months postsurgery. METHODS The authors reviewed images and medical records of patients ≥ 16 years of age with a diagnosis of an isolated single-level, low-grade spondylolisthesis (degenerative or isthmic) with symptomatic spinal stenosis treated between January 2008 and April 2014. Age, sex, surgical level, surgical approach, and facetectomy (unilateral vs bilateral) were recorded. Upright standardized preoperative, early, and 6-month postoperative radiographs, as well as intraoperative lateral radiographs, were analyzed for the pelvic incidence, segmental lumbar lordosis (SLL) at the TILF level, and total LL (TLL). In addition, the anteroposterior position of the cage in the disc space was documented. Data are presented as the mean ± SD; a p value < 0.05 was considered significant. RESULTS Eighty-four patients were included in the study. The mean age of patients was 56.8 ± 13.7 years, and 46 patients (55%) were men. The mean pelvic incidence was 59.7° ± 11.9°, and a posterior midline approach was used in 47 cases (56%). All TLIF procedures were single level using a bullet-shaped cage. A bilateral facetectomy was performed in 17 patients (20.2%), and 89.3% of procedures were done at the L4-5 and L5-S1 segments. SLL significantly improved intraoperatively from 15.8° ± 7.5° to 20.9° ± 7.7°, but the correction was lost after ambulation. Compared with preoperative values, at 6 months the change in SLL was modest at 1.8° ± 6.7° (p = 0.025), whereas TLL increased by 4.3° ± 9.6° (p < 0.001). The anteroposterior position of the cage, approach, level of surgery, and use of a bilateral facetectomy did not significantly affect postoperative LL

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.

Radiographic Analysis of One-level Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF) With Unilateral Pedicle Screw Fixation for Lumbar Degenerative Diseases.

PubMed

Shen, Xiaolong; Wang, Lei; Zhang, Hailong; Gu, Xin; Gu, Guangfei; He, Shisheng

2016-02-01

A prospective randomized study was conducted. The purpose of this study was to assess the radiographic outcomes of one-level minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) with unilateral pedicle screw instrumentation for degenerative lumbar spine disease. MI-TLIF has become an increasingly popular method of lumbar arthrodesis. Recent technological advances in spinal instrumentation have culminated in the development of MI-TLIF with unilateral pedicle screw fixation. However, there are few published studies on radiographic outcomes of the MI-TLIF with unilateral pedicle screw fixation. A total of 65 patients with one-level degenerative lumbar spine disease were enrolled in this study. Patients were randomized into the unilateral or bilateral fixation group based on a computer-generated number list. Thirty-one patients (17 men and 14 women; average age, 57.3 y) were randomized to the unilateral group (group A) and 34 patients (16 men and 18 women; average age, 58.9 y) to the bilateral group (group B). All patients underwent minimally invasive decompression, interbody fusion, and pedicle screw fixation with the assistance of microscopic tubular retractor system (METRx-MD) and Sextant system. All patients were asked to follow-up at 3, 6, and thereafter once every 6 months after surgery. The visual analog scale (VAS), Oswestry disability index (ODI), and modified Prolo (mProlo) scores were obtained for all patients 24 hours before the operation and at each follow-up visit. The whole lumbar lordosis (WL), the segmental lordosis (SL), fusion level disk space angle, lumbar scoliosis angle, and segmental scoliosis angle were determined before and after surgery on standard x-rays. The disk height index (DI) and the lumber curvature index (LI) were also evaluated. The mean follow-up was 26.6 months, with a range of 18-36 months. All patients showed evidence of fusion at 12 months postoperatively. Statistically, there was no significant difference between

Endoscopic colloid cyst excision: surgical techniques and nuances.

PubMed

Azab, Waleed Abdelfattah; Najibullah, Mustafa; Yosef, Waleed

2017-06-01

Endoscopic excision of colloid cysts is currently well established as a minimally invasive and highly effective technique that is associated with less morbidity in comparison to microsurgical resection. Operative charts and videos of patients undergoing endoscopic colloid cyst excision were retrieved from the senior author's database of endoscopic procedures and reviewed. This revealed nine trans-foraminal and three trans-septal procedures. Description of the surgical techniques was then formulated. Variation of the technique is based on the specific patho-anatomical features of the colloid cyst being resected. For the trans-foraminal approach, we think that the rotational technique is associated with a more complete removal of the cyst wall and consequently lower recurrence rate.

[Anterior lumbar interbody fusion. Indications, technique, advantages and disadvantages].

PubMed

Richter, M; Weidenfeld, M; Uckmann, F P

2015-02-01

Anterior lumbar interbody fusion (ALIF) for lumbar interbody fusion from L2 to the sacrum has been an established technique for decades. The advantages and disadvantages of ALIF compared to posterior interbody fusion techniques are discussed. The operative technique is described in detail. Complications and avoidance strategies are discussed. This article is based on a selective literature search using PubMed and the experience of the authors in this medical field. The advantages of ALIF compared to posterior fusion techniques are the free approach to the anterior disc space without opening of the spinal canal or the neural foramina. This gives the possibility of an extensive anterior release and placement of the largest possible cages without the risk of neural structure damage. The disadvantages of ALIF are the additional anterior approach and the related complications. The most frequent complication is due to damage of vessels. The rate of complications is significantly increased in revision surgery. The ALIF technique meaningfully expands the repertoire of the spinal surgeon especially for the treatment of non-union after interbody fusion, in patients with epidural scar tissue at the index level and spinal infections. Advantages and disadvantages should be considered when evaluating the indications for ALIF.

AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion

PubMed Central

Rapp, Steven M; Miller, Larry E; Block, Jon E

2011-01-01

Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF) system is a minimally invasive fusion device that accesses the lumbar (L4–S1) intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date. PMID:22915939

AxiaLIF system: minimally invasive device for presacral lumbar interbody spinal fusion.

PubMed

Rapp, Steven M; Miller, Larry E; Block, Jon E

2011-01-01

Lumbar fusion is commonly performed to alleviate chronic low back and leg pain secondary to disc degeneration, spondylolisthesis with or without concomitant lumbar spinal stenosis, or chronic lumbar instability. However, the risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (AxiaLIF) system is a minimally invasive fusion device that accesses the lumbar (L4-S1) intervertebral disc spaces via a reproducible presacral approach that avoids critical neurovascular and musculoligamentous structures. Since the AxiaLIF system received marketing clearance from the US Food and Drug Administration in 2004, clinical studies of this device have reported high fusion rates without implant subsidence, significant improvements in pain and function, and low complication rates. This paper describes the design and approach of this lumbar fusion system, details the indications for use, and summarizes the clinical experience with the AxiaLIF system to date.

Complications with axial presacral lumbar interbody fusion: A 5-year postmarketing surveillance experience

PubMed Central

Gundanna, Mukund I.; Miller, Larry E.; Block, Jon E.

2011-01-01

Background Open and minimally invasive lumbar fusion procedures have inherent procedural risks, with posterior and transforaminal approaches resulting in significant soft-tissue injury and the anterior approach endangering organs and major blood vessels. An alternative lumbar fusion technique uses a small paracoccygeal incision and a presacral approach to the L5-S1 intervertebral space, which avoids critical structures and may result in a favorable safety profile versus open and other minimally invasive fusion techniques. The purpose of this study was to evaluate complications associated with axial interbody lumbar fusion procedures using the Axial Lumbar Interbody Fusion (AxiaLIF) System (TranS1, Wilmington, North Carolina) in the postmarketing period. Methods Between March 2005 and March 2010, 9,152 patients underwent interbody fusion with the AxiaLIF System through an axial presacral approach. A single-level L5-S1 fusion was performed in 8,034 patients (88%), and a 2-level (L4-S1) fusion was used in 1,118 (12%). A predefined database was designed to record device- or procedure-related complaints via spontaneous reporting. The complications that were recorded included bowel injury, superficial wound and systemic infections, transient intraoperative hypotension, migration, subsidence, presacral hematoma, sacral fracture, vascular injury, nerve injury, and ureter injury. Results Complications were reported in 120 of 9,152 patients (1.3%). The most commonly reported complications were bowel injury (n = 59, 0.6%) and transient intraoperative hypotension (n = 20, 0.2%). The overall complication rate was similar between single-level (n = 102, 1.3%) and 2-level (n = 18, 1.6%) fusion procedures, with no significant differences noted for any single complication. Conclusions The 5-year postmarketing surveillance experience with the AxiaLIF System suggests that axial interbody lumbar fusion through the presacral approach is associated with a low incidence of complications

Can Fan-Beam Interactive Computed Tomography Accurately Predict Indirect Decompression in Minimally Invasive Spine Surgery Fusion Procedures?

PubMed

Janssen, Insa; Lang, Gernot; Navarro-Ramirez, Rodrigo; Jada, Ajit; Berlin, Connor; Hilis, Aaron; Zubkov, Micaella; Gandevia, Lena; Härtl, Roger

2017-11-01

Recently, novel mobile intraoperative fan-beam computed tomography (CT) was introduced, allowing for real-time navigation and immediate intraoperative evaluation of neural decompression in spine surgery. This study sought to investigate whether intraoperatively assessed neural decompression during minimally invasive spine surgery (MISS) has a predictive value for clinical and radiographic outcome. A retrospective study of patients undergoing intraoperative CT (iCT)-guided extreme lateral interbody fusion or transforaminal lumbar interbody fusion was conducted. 1) Preoperative, 2) intraoperative (after cage implantation, 3) postoperative, and 4) follow-up radiographic and clinical parameters obtained from radiography or CT were quantified. Thirty-four patients (41 spinal segments) were analyzed. iCT-based navigation was successfully accomplished in all patients. Radiographic parameters showed significant improvement from preoperatively to intraoperatively after cage implantation in both MISS procedures (extreme lateral interbody fusion/transforaminal lumbar interbody fusion) (P ≤ 0.05). Radiologic parameters for both MISS fusion procedures did not show significant differences to the assessed radiographic measures at follow-up (P > 0.05). Radiologic outcome values did not decrease when compared intraoperatively (after cage implantation) to latest follow-up. Intraoperative fan-beam CT is capable of assessing neural decompression intraoperatively with high accuracy, allowing for precise prediction of radiologic outcome and earliest possible feedback during MISS fusion procedures. These findings are highly valuable for routine practice and future investigations toward finding a threshold for neural decompression that translates into clinical improvement. If sufficient neural decompression has been confirmed with iCT imaging studies, additional postoperative and/or follow-up imaging studies might no longer be required if patients remain asymptomatic. Copyright © 2017

Comparative Prospective Study Reporting Intraoperative Parameters, Pedicle Screw Perforation, and Radiation Exposure in Navigation-Guided versus Non-navigated Fluoroscopy-Assisted Minimal Invasive Transforaminal Lumbar Interbody Fusion

PubMed Central

Kundnani, Vishal; Dutta, Shumayou; Patel, Ankit; Mehta, Gaurav; Singh, Mahendra

2018-01-01

Study Design Prospective cohort study. Purpose To compare intraoperative parameters, radiation exposure, and pedicle screw perforation rate in navigation-guided versus non-navigated fluoroscopy-assisted minimal invasive transforaminal lumbar interbody fusion (MIS TLIF). Overview of Literature The poor reliability of fluoroscopy-guided instrumentation and growing concerns about radiation exposure have led to the development of navigation-guided instrumentation techniques in MIS TLIF. The literature evaluating the efficacy of navigation-guided MIS TLIF is scant. Methods Eighty-seven patients underwent navigation- or fluoroscopy-guided MIS TLIF for symptomatic lumbar/lumbosacral spondylolisthesis. Demographics, intraoperative parameters (surgical time, blood loss), and radiation exposure (sec/mGy/Gy.cm2 noted from C-arm for comparison only) were recorded. Computed tomography was performed in patients in the navigation and non-navigation groups at postoperative 12 months and reviewed by an independent observer to assess the accuracy of screw placement, perforation incidence, location, grade (Mirza), and critical versus non-critical neurological implications. Results Twenty-seven patients (male/female, 11/16; L4–L5/L5–S1, 9/18) were operated with navigation-guided MIS TLIF, whereas 60 (male/female, 25/35; L4–L5/L5–S1, 26/34) with conventional fluoroscopy-guided MIS TILF. The use of navigation resulted in reduced fluoroscopy usage (dose area product, 0.47 Gy.cm2 versus 2.93 Gy.cm2), radiation exposure (1.68 mGy versus 10.97 mGy), and fluoroscopy time (46.5 seconds versus 119.08 seconds), with p-values of <0.001. Furthermore, 96.29% (104/108) of pedicle screws in the navigation group were accurately placed (grade 0) (4 breaches, all grade I) compared with 91.67% (220/240) in the non-navigation group (20 breaches, 16 grade I+4 grade II; p=0.114). None of the breaches resulted in a corresponding neurological deficit or required revision. Conclusions Navigation

Biomechanical analysis of an expandable lateral cage and a static transforaminal lumbar interbody fusion cage with posterior instrumentation in an in vitro spondylolisthesis model.

PubMed

Mantell, Matthew; Cyriac, Mathew; Haines, Colin M; Gudipally, Manasa; O'Brien, Joseph R

2016-01-01

Insufficient biomechanical data exist from comparisons of the stability of expandable lateral cages with that of static transforaminal lumbar interbody fusion (TLIF) cages. The purpose of this biomechanical study was to compare the relative rigidity of L4-5 expandable lateral interbody constructs with or without additive pedicle screw fixation with that of L4-5 static TLIF cages in a novel cadaveric spondylolisthesis model. Eight human cadaver spines were used in this study. A spondylolisthesis model was created at the L4-5 level by creating 2 injuries. First, in each cadaver, a nucleotomy from 2 channels through the anterior side was created. Second, the cartilage of the facet joint was burred down to create a gap of 4 mm. Light-emitting-diode tracking markers were placed at L-3, L-4, L-5, and S-1. Specimens were tested in the following scenarios: intact model, bilateral pedicle screws, expandable lateral 18-mm-wide cage (alone, with unilateral pedicle screws [UPSs], and with bilateral pedicle screws [BPSs]), expandable lateral 22-mm-wide cage (alone, with UPSs, and with BPSs), and TLIF (alone, with UPSs, and with BPSs). Four of the spines were tested with the expandable lateral cages (18-mm cage followed by the 22-mm cage), and 4 of the spines were tested with the TLIF construct. All these constructs were tested in flexion-extension, axial rotation, and lateral bending. The TLIF-alone construct was significantly less stable than the 18- and 22-mm-wide lateral lumbar interbody fusion (LLIF) constructs and the TLIF constructs with either UPSs or BPSs. The LLIF constructs alone were significantly less stable than the TLIF construct with BPSs. However, there was no significant difference between the 18-mm LLIF construct with UPSs and the TLIF construct with BPSs in any of the loading modes. Expandable lateral cages with UPSs provide stability equivalent to that of a TLIF construct with BPSs in a degenerative spondylolisthesis model.

Effect of transforaminal epidural polydeoxyribonucleotide injections on lumbosacral radiculopathy: A case report.

PubMed

Kang, Keum Nae; Kim, Tae Woong; Koh, Jin Woo; Oh, Han Byeol; Mun, Jong-Uk; Seo, Mi Sook; Kim, Young Uk

2017-06-01

Transforaminal epidural glucocorticoids administration is widely performed for the management of lumbosacral radiculopathy. However, it may worsen the condition of patients with type 2 diabetes mellitus (DM). Polydeoxyribonucleotide (PDRN) was recently noted as a substitute for glucocorticoids. A 44-year-old male patient was admitted to our pain clinic with symptoms of low back pain with severe pain and tingling sensation of left posterolateral leg. He had type 2 DM medicated with Glimepiride and Metformin. Blood glucose level was 367 mg/dL. He declined to use glucocorticoid. He was diagnosed as left foraminal disc protrusion at L4-5, left subarticular disc protrusion at L5-S1. Fluoroscopically guided transforaminal epidural PDRN injections were carried out. The patient was followed up for more than 6 months and demonstrated good improvement in lumbosacral radiculopathy without any complications. This is the first successful report on epidural injection of PDRN.

Results of instrumented posterolateral fusion in treatment of lumbar spondylolisthesis with and without segmental kyphosis: A retrospective investigation.

PubMed

Chen, Szu-Yuan; Lu, Meng-Ling; Niu, Chi-Chien; Tsai, Tsung-Ting; Liao, Jen-Chung; Chen, Lih-Huei; Chen, Wen-Jer

2015-01-01

Treatment by posterolateral fusion (PLF) with pedicle-screw instrumentation can be unsuccessful in one-segment and low-grade lumbar spondylolisthesis. Segmental kyphosis, either rigid or dynamic, was hypothesized to be one of the factors interfering with the fusion results. From 2004 to 2005, 239 patients with single-segment and low-grade spondylolisthesis were recruited and divided into two groups: Group 1 consisting of 129 patients without segmental kyphosis and group 2 consisting of 110 patients with segmental kyphosis. All patients underwent instrumented PLF at the same medical institute, and the average follow-up period was 31 ± 19 months. We obtained plain radiographs of the lumbosacral spine with the anteroposterior view, the lateral view, and the dynamic flexion-extension views before the operation and during the follow-ups. The results of PLF in the two groups were then compared. There was no significant difference in the demographic data of the two groups, except for gender distribution. The osseous fusion rates were 90.7% in group 1 and 68.2% in group 2 (p < 0.001). Instrumented PLF resulted in significantly higher osseous fusion rate in patients without segmental kyphosis than in the patients with segmental kyphosis. For the patients with sagittal imbalance, such as rigid or dynamic kyphosis, pedicle-screw fixation cannot ensure successful PLF. Interbody fusion by the posterior lumbar interbody fusion or transforaminal lumbar interbody fusion technique might help overcome this problem.

Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain

PubMed Central

2013-01-01

Background Transforaminal epidural steroid injections are known to reduce inflammation by inhibiting synthesis of various proinflammatory mediators and have been used increasingly. The anti-inflammatory properties of opioids are not as fully understood but apparently involve antagonism sensory neuron excitability and pro-inflammatory neuropeptide release. To date, no studies have addressed the efficacy of transforaminal epidural morphine in patients with radicular pain, and none have directly compared morphine with a tramadol for this indication. The aim of this study was to compare morphine and tramadol analgesia when administered via epidural injection to patients with lumbar radicular pain. Methods A total of 59 patients were randomly allocated to 1 of 2 treatment groups and followed for 3 months after procedure. Each patient was subjected to C-arm guided transforaminal epidural injection (TFEI) of an affected nerve root. As assigned, patients received either morphine sulfate (2.5 mg/2.5 ml) or tramadol (25 mg/0.5 ml) in combination with 0.2% ropivacaine (1 ml). Using numeric rating scale was subsequently rates at 2 weeks and 3 months following injection for comparison with baseline. Results Both groups had significantly lower mean pain scores at 2 weeks and at 3 months after treatment, but outcomes did not differ significantly between groups. Conclusions TFEI of an opioid plus local anesthetic proved effective in treating radicular pain. Although morphine surpassed tramadol in pain relief scores, the difference was not statistically significant. PMID:23862000

One-stage posterior approaches for treatment of thoracic spinal infection: Transforaminal and costotransversectomy, compared with anterior approach with posterior instrumentation.

PubMed

Kao, Fu-Cheng; Tsai, Tsung-Ting; Niu, Chi-Chien; Lai, Po-Liang; Chen, Lih-Huei; Chen, Wen-Jer

2017-10-01

Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed.The clinical outcomes of patients treated with 1-stage posterior approaches were generally good, with good infection control, back pain relief, kyphotic angle correction, and either partial or solid union for fusion status. Furthermore, they achieved shorter surgical time, fewer postoperative complications, and shorter hospital stay than the patients underwent anterior debridement with posterior instrumentation.The results suggested that treating thoracic spondylodiscitis with a single-stage posterior approach might prevent postoperative complications and avoid respiratory problems associated with anterior approaches. Single-stage posterior approaches would be recommended for thoracic spine infection, especially for patients with medical comorbidities.

Extraforaminal needle tip position reduces risk of intravascular injection in CT-fluoroscopic lumbar transforaminal epidural steroid injections

PubMed Central

Yu, Robinson K.; Ghodadra, Anish; Agarwal, Vikas

2016-01-01

Background Lumbar transforaminal epidural steroid injection is a common and effective tool for managing lumbar radicular pain, although accidental intravascular injection can rarely result in paralysis. The purpose of this study is to determine the safest needle tip position for computed tomography (CT)-guided lumbar transforaminal epidural steroid injections as determined by incidence of intravascular injection. Methods Three radiologists, in consensus, reviewed procedural imaging for consecutive CT-fluoroscopic lumbar transforaminal epidural steroid injections performed during a 16-month period. Intravascular injections were identified and categorized by needle tip position, vessel type injected, intravascular injection volume and procedural phase containing the intravascular injection. Pearson chi-square and logistic regression testing were used to assess differences between groups, as appropriate. Results Intravascular injections occurred in 9% (52/606) of injections. The intravascular injection rate was significantly lower (P<0.001) for extraforaminal needle position (0%, 0/109) compared to junctional (8%, 27/319) and foraminal (14%, 25/178) needle tip positions. Of the intravascular injections, 4% (2/52) were likely arterial, 35% (18/52) were likely venous, and 62% (32/52) were indeterminate for vessel type injected. 46% (24/52) of intravascular injections were large volume, 33% (17/52) were small volume, and 21% (11/52) were trace volume. 56% (29/52) of intravascular injections occurred with the contrast trial dose, 29% (15/52) with the steroid/analgesic cocktail, and 15% (8/52) with both. Conclusions An extraforaminal needle position for CT-fluoroscopic lumbar transforaminal epidural steroid injections decreases the risk of intravascular injection and therefore may be safer than other needle tip positions. PMID:28097241

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

Preservation or Restoration of Segmental and Regional Spinal Lordosis Using Minimally Invasive Interbody Fusion Techniques in Degenerative Lumbar Conditions: A Literature Review.

PubMed

Uribe, Juan S; Myhre, Sue Lynn; Youssef, Jim A

2016-04-01

A literature review. The purpose of this study was to review lumbar segmental and regional alignment changes following treatment with a variety of minimally invasive surgery (MIS) interbody fusion procedures for short-segment, degenerative conditions. An increasing number of lumbar fusions are being performed with minimally invasive exposures, despite a perception that minimally invasive lumbar interbody fusion procedures are unable to affect segmental and regional lordosis. Through a MEDLINE and Google Scholar search, a total of 23 articles were identified that reported alignment following minimally invasive lumbar fusion for degenerative (nondeformity) lumbar spinal conditions to examine aggregate changes in postoperative alignment. Of the 23 studies identified, 28 study cohorts were included in the analysis. Procedural cohorts included MIS ALIF (two), extreme lateral interbody fusion (XLIF) (16), and MIS posterior/transforaminal lumbar interbody fusion (P/TLIF) (11). Across 19 study cohorts and 720 patients, weighted average of lumbar lordosis preoperatively for all procedures was 43.5° (range 28.4°-52.5°) and increased 3.4° (9%) (range -2° to 7.4°) postoperatively (P < 0.001). Segmental lordosis increased, on average, by 4° from a weighted average of 8.3° preoperatively (range -0.8° to 15.8°) to 11.2° at postoperative time points (range -0.2° to 22.8°) (P < 0.001) in 1182 patient from 24 study cohorts. Simple linear regression revealed a significant relationship between preoperative lumbar lordosis and change in lumbar lordosis (r = 0.413; P = 0.003), wherein lower preoperative lumbar lordosis predicted a greater increase in postoperative lumbar lordosis. Significant gains in both weighted average lumbar lordosis and segmental lordosis were seen following MIS interbody fusion. None of the segmental lordosis cohorts and only two of the 19 lumbar lordosis cohorts showed decreases in lordosis postoperatively. These results suggest that

[Clinical outcomes of single-level lumbar spondylolisthesis by minimally invasive transforaminal lumbar interbody fusion with bilateral tubular channels].

PubMed

Zeng, Z L; Jia, L; Yu, Y; Xu, W; Hu, X; Zhan, X H; Jia, Y W; Wang, J J; Cheng, L M

2017-04-01

Objective: To evaluate the clinical effectiveness of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for single-level lumbar spondylolisthesis treatment with bilateral Spotlight tubular channels. Methods: A total of 21 patients with lumbar spondylolisthesis whom underwent MIS-TLIF via bilateral Spotlight tubular channels were retrospectively analyzed from October 2014 to November 2015. The 21 patients included 11 males and 10 females ranged from 35 to 82 years (average aged 60.7 years). In term of spondylolisthesis category, there were 18 cases of degenerative spondylolisthesis and 3 cases of isthmic spondylolisthesis. With respect to spondylolisthesis degree, 17 cases were grade Ⅰ° and 4 cases were grade Ⅱ°. Besides, 17 cases at L(4-5) and 4 cases at L(5)-S(1)were categorized by spondylolisthesis levels. Operation duration, blood loss, postoperative drainage and intraoperative exposure time were recorded, functional improvement was defined as an improvement in the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) was also employed at pre and post-operation (3 months and the last follow-up), to evaluate low back and leg pain. Furthermore, to evaluate the recovery of the intervertebral foramen and of lumbar sagittal curvature, average height of intervertebral space, Cobb angles of lumbar vertebrae and operative segments, spondylolisthesis index were measured. At the last follow-up, intervertebral fusion was assessed using Siepe evaluation criteria and the clinical outcome was assessed using the MacNab scale. Radiographic and functional outcomes were compared pre- and post-operation using the paired T test to determine the effectiveness of MIS-TLIF. Statistical significance was defined as P <0.05. Results: All patients underwent a successful MIS-TLIF surgery. The operation time (235.2±30.2) mins, intraoperative blood loss (238.1±130.3) ml, postoperative drainage (95.7±57.1) ml and intraoperative radiation exposure (47.1±8

Occipitocervical fusion in skeletal dysplasia: a new surgical technique.

PubMed

Sitoula, Prakash; Mackenzie, William G; Shah, Suken A; Thacker, Mihir; Ditro, Colleen; Holmes, Laurens; Campbell, Jeffrey W; Rogers, Kenneth J

2014-07-01

Retrospective cohort study. This study describes clinical and radiological results of a new cable technique for occipitocervical fusion (OCF) in children with skeletal dysplasia (SD). Anatomical variability and poor bone quality make upper cervical surgery technically challenging in patients with SD. We present a new cable technique for OCF in children with SD when the posterior elements are not of a size or quality for other types of instrumentation. Retrospective review of 24 patients with SD (8 boys, 16 girls) who underwent OCF between 2001 and 2011. In this technique, cables provide compression across a bone graft that is prevented from entering the canal and the graft resists excessive lordosis. Demographic and radiographical data are presented. All patients were followed for initial outcomes of surgery, and 20 patients (83%) were followed for 2 years or more for mid- and long-term outcomes. Mean age at surgery was 6.5 years and mean follow-up was 4.1 ± 2.4 years. This technique was used as a primary procedure in 20 and a revision procedure in 4 patients. Diagnoses included Morquio syndrome (6), spondyloepiphyseal dysplasia (9), spondyloepimetaphyseal dysplasia (5), metatropic dysplasia (3), and Kniest syndrome (1). Ten patients had upper cervical instability and features of cervical myelopathy, and the remaining 14 patients had instability and signal changes on magnetic resonance image. Fusion extended from occiput to C2 in 71% patients, and upper cervical decompression was needed in 92% patients. Postoperatively, all patients were immobilized in a halo vest for mean duration of 12 weeks. Fusion was achieved in all patients. Complications included halo pin-tract infections (7), junctional instability (2), and extension of fusion (4). This new cable technique is a good alternative for OCF in patients with SD who have altered anatomy at the craniocervical junction not amenable to rigid internal fixation. 4.

A prospective, multi-institutional comparative effectiveness study of lumbar spine surgery in morbidly obese patients: does minimally invasive transforaminal lumbar interbody fusion result in superior outcomes?

PubMed

Adogwa, Owoicho; Carr, Kevin; Thompson, Paul; Hoang, Kimberly; Darlington, Timothy; Perez, Edgar; Fatemi, Parastou; Gottfried, Oren; Cheng, Joseph; Isaacs, Robert E

2015-05-01

Obese and morbidly obese patients undergoing lumbar spinal fusion surgery are a challenge to the operating surgeon. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open-TLIF have been performed for many years with good results; however, functional outcomes after lumbar spine surgery in this subgroup of patients remain poorly understood. Furthermore, whether index MIS-TLIF or open-TLIF for the treatment of degenerative disc disease or spondylolisthesis in morbidly obese results in superior postoperative functional outcomes remains unknown. A total of 148 (MIS-TLIF: n = 40, open-TLIF: n = 108) obese and morbidly obese patients undergoing index lumbar arthrodesis for low back pain and/or radiculopathy between January 2003 and December 2010 were selected from a multi-institutional prospective data registry. We collected and analyzed data on patient demographics, postoperative complications, back pain, leg pain, and functional disability over 2 years. Patients completed the Oswestry Disability Index (ODI), Medical Outcomes Study Short-Form 36 (SF-36), and back and leg pain numerical rating scores before surgery and then at 12 and 24 months after surgery. Clinical outcomes and complication rates were compared between both patient cohorts. Compared with preoperative status, Visual Analog Scale (VAS) back and leg pain, ODI, and SF-36 physical component score/mental component score were improved in both groups. Both MIS-TLIF and open-TLIF patients showed similar 2-year improvement in VAS for back pain (MIS-TLIF: 2.42 ± 3.81 vs. open-TLIF: 2.33 ± 3.67, P = 0.89), VAS for leg pain (MIS-TLIF: 3.77 ± 4.53 vs. open-TLIF: 2.67 ± 4.10, P = 0.18), ODI (MIS-TLIF: 11.61 ± 25.52 vs. open-TLIF: 14.88 ± 22.07, P = 0.47), and SF-36 physical component score (MIS-TLIF: 8.61 ± 17.72 vs. open-TLIF: 7.61 ± 15.55, P = 0.93), and SF-36 mental component score (MIS-TLIF: 4.35 ± 22.71 vs. open-TLIF: 5.96 ± 21.09, P = 0.69). Postoperative complications

Associated lumbar scoliosis does not affect outcomes in patients undergoing focal minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF) for neurogenic symptoms-a minimum 2-year follow-up study.

PubMed

Tay, Kae Sian; Bassi, Anupreet; Yeo, William; Yue, Wai Mun

2017-01-01

There is no current literature comparing outcomes of patients with and without lumbar scoliosis having neurologic symptoms undergoing minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF) technique. This study aimed to determine whether associated lumbar scoliosis will result in different clinical, radiological, and operative outcomes in patients undergoing focal MISTLIF for neurogenic symptoms, without specific correction of the scoliosis. A retrospective case comparison study from prospectively collected hospital registry data was carried out. Two hundred and thirty eligible patients were evaluated and divided into two groups: Scoliosis Group (SG; n=57) with Cobb angle >10 degrees on anterioposterior (AP) plain lumbar spine radiographs and Non-Scoliosis Group (NSG; n=173) consisting of the remaining patients. Clinical outcomes were assessed using the Oswestry Disability Index, the North American Spine Society (NASS) Neurogenic Symptom Score, the NASS Satisfaction with Surgery Rating, the 36-Item Short-Form Health Survey (SF-36), and the Numerical Pain Rating Scale for back and leg pain. Radiological findings included Cobb angle, fusion, implant failure or loosening, and adjacent segment degeneration (ASD). Both groups were compared for demographics, perioperative parameters, complications, clinical, and radiological outcomes. Interobserver agreement (kappa statistics) for measurement of Cobb angle was calculated on all cases of both groups by two authors. Patients were evaluated preoperatively, at 6 months, and 2 years after surgery. The average follow-up was 2.88±1.47 years in the SG and 2.71±1.34 years in the NSG (p=.444). Differences in mean age (SG: 62.9±10.9 years and NSG: 57.6±13.1 years), estimated related risk of death (SG: 3.05±2.13 and NSG: 2.41±1.74), and gender (female=SG: 87.7% and NSG: 64.2%) were statistically significant (p<.05), whereas race distribution, body mass index |(BMI), spinal levels operated, number of levels

Higher Improvement in Patient-Reported Outcomes Can Be Achieved After Transforaminal Lumbar Interbody Fusion for Clinical and Radiographic Degenerative Spondylolisthesis Classification Type D Degenerative Lumbar Spondylolisthesis.

PubMed

Chen, Xi; Xu, Liang; Qiu, Yong; Chen, Zhong-Hui; Zhou, Qing-Shuang; Li, Song; Sun, Xu

2018-06-01

Clinical and radiographic degenerative spondylolisthesis (CARDS) classification defines a distinct subset of patients with kyphotic angulation at the involved segment (type D). Research using CARDS classification to investigate motion characteristics at involved segments or patient-related outcomes (PROs) following surgical intervention is sparse. We investigated the relationship between CARDS type D spondylolisthesis and dynamic instability and PROs in type D versus non-type D spondylolisthesis. We reviewed consecutive patients who received transforaminal lumbar interbody fusion for L4-5 spondylolisthesis between 2009 and 2015. Patients were assigned into type D and non-type D groups. Translational motion was determined by upright lumbar lateral radiography with supine sagittal magnetic resonance imaging or flexion and extension radiography. Demographics, radiographic parameters, and PROs were evaluated. Type D and non-type D groups comprised 34 and 163 patients, respectively. Compared with non-type D, type D group was characterized by lordotic angulation loss and higher degree of olisthesis on upright radiographs and demonstrated higher translational motion on upright lumbar lateral radiography with supine sagittal magnetic resonance imaging analysis. After surgery, mean reduction rate was significantly higher in type D group; type D had less slippage, but differences in slip angle and disc height were not significant. Preoperative Oswestry Disability Index and visual analog scale for back pain scores were higher in type D group. Type D spondylolisthesis and dynamic instability were associated with achieving minimal clinically important differences in PROs. CARDS type D spondylolisthesis is a distinct subset associated with dynamic instability and worse PROs. Higher improvement in PROs can be achieved in CARDS type D spondylolisthesis after surgery. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life.

PubMed

Adogwa, Owoicho; Parker, Scott L; Bydon, Ali; Cheng, Joseph; McGirt, Matthew J

2011-12-01

Retrospective cohort comparison between minimally invasive (MIS) and open transforaminal lumbar interbody fusion (TLIF). To assess 2 earlier unstudied endpoints (duration of narcotic use and return to work) and long-term pain, disability, and quality of life (QOL) for MIS-TLIF versus open-TLIF. MIS-TLIF for lumbar spondylolithesis theoretically allows for surgical treatment of back and leg pain while minimizing blood loss and tissue injury. Although earlier studies have shown shorter hospital stay and equivocal 6 and 24 month outcomes with MIS-TLIF versus open-TLIF, the effect of MIS techniques on postoperative narcotic use and return to work are poorly understood. Thirty patients undergoing MIS-TLIF (n = 15) or open-TLIF (n = 15) for grade I degenerative spondylolithesis-associated back and leg pain were enrolled. Two-year outcomes were assessed through phone interview and it included pain [visual analog scale (VAS)], low-back disability (Oswestry disability index), EuroQol-5D, occupational disability, and narcotic use. MIS-TLIF versus open-TLIF cohorts were similar at baseline. Median [interquartile range (IQR)] length of hospitalization after surgery was significantly less for MIS-TLIF versus open-TLIF [3 (3 to 3) vs 5.5 (4 to 6) d], P = 0.001. MIS-TLIF versus open-TLIF patients showed similar 2-year improvement in VAS for back pain, VAS for leg pain, Oswestry disability index, and EuroQol-5D scores. Overall, median (IQR) length of postoperative narcotic use was 3.0 (1.4 to 4.6) weeks and significantly shorter for MIS-TLIF versus open-TLIF patients [2.0 (1.0 to 3.0) vs 4.0 (1.4 to 4.6) wk, P = 0.008]. Overall, median (IQR) time to return to work was 13.9 (2.2 to 25.5) weeks and significantly shorter for MIS-TLIF versus open-TLIF patients [8.5 (4.4 to 21.4) vs 17.1 (1.8 to 35.9) wk, P = 0.02]. Both MIS-TLIF and open-TLIF provide long-term improvement in pain, disability, and EuroQol-5D in patients with back and leg pain from grade I degenerative spondylolithesis

In vitro comparison of endplate preparation between four mini-open interbody fusion approaches.

PubMed

Tatsumi, Robert; Lee, Yu-Po; Khajavi, Kaveh; Taylor, William; Chen, Foster; Bae, Hyun

2015-04-01

Discectomy and endplate preparation are important steps in interbody fusion for ensuring sufficient arthrodesis. While modern less-invasive approaches for lumbar interbody fusion have gained in popularity, concerns exist regarding their ability to allow for adequate disc space and endplate preparation. Thus, the purpose of this study was to quantitatively and qualitatively evaluate and compare disc space and endplate preparation achieved with four less-invasive approaches for lumbar interbody fusion in cadaveric spines. A total of 24 disc spaces (48 endplates) from L2 to L5 were prepared in eight cadaveric torsos using mini-open anterior lumbar interbody fusion (mini-ALIF), minimally invasive posterior lumbar interbody fusion (MAS PLIF), minimally invasive transforaminal lumbar interbody fusion (MAS TLIF) or minimally invasive lateral, transpsoas interbody fusion (XLIF) on two specimens each, for a total of six levels and 12 endplates prepared per procedure type. Following complete discectomy and endplate preparation, spines were excised and split axially at the interbody disc spaces. Endplates were digitally photographed and evaluated using image analysis software. Area of endplate preparation was measured and qualitative evaluation was also performed to grade the quality of preparation. The XLIF approach resulted in the greatest relative area of endplate preparation (58.3 %) while mini-ALIF resulted in the lowest at 35.0 %. Overall, there were no differences in percentage of preparation between cranial and caudal endplates, though this was significantly different in the XLIF group (65 vs 52 %, respectively). ALL damage was observed in 3 MAS TLIF levels. Percentage of endplate that was deemed to have complete disc removal was highest in XLIF group with 90 % compared to 65 % in MAS TLIF group, 43 % in MAS PLIF, and 40 % in mini-ALIF group. Endplate damage area was highest in the MAS TLIF group at 48 % and lowest in XLIF group at 4 %. These results demonstrate that

The cost-effectiveness of interbody fusions versus posterolateral fusions in 137 patients with lumbar spondylolisthesis.

PubMed

Bydon, Mohamad; Macki, Mohamed; Abt, Nicholas B; Witham, Timothy F; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Bydon, Ali; Sciubba, Daniel M

2015-03-01

Reimbursements for interbody fusions have declined recently because of their questionable cost-effectiveness. A Markov model was adopted to compare the cost-effectiveness of posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (/TLIF) versus noninterbody fusion and posterolateral fusion (PLF) in patients with lumbar spondylolisthesis. Decision model analysis based on retrospective data from a single institutional series. One hundred thirty-seven patients underwent first-time instrumented lumbar fusions for degenerative or isthmic spondylolisthesis. Quality of life adjustments and expenditures were assigned to each short-term complication (durotomy, surgical site infection, and medical complication) and long-term outcome (bowel/bladder dysfunction and paraplegia, neurologic deficit, and chronic back pain). Patients were divided into a PLF cohort and a PLF plus PLIF/TLIF cohort. Anterior techniques and multilevel interbody fusions were excluded. Each short-term complication and long-term outcome was assigned a numerical quality-adjusted life-year (QALY), based on time trade-off values in the Beaver Dam Health Outcomes Study. The cost data for short-term complications were calculated from charges accrued by the institution's finance sector, and the cost data for long-term outcomes were estimated from the literature. The difference in cost of PLF plus PLIF/TLIF from the cost of PLF alone divided by the difference in QALY equals the cost-effectiveness ratio (CER). We do not report any study funding sources or any study-specific appraisal of potential conflict of interest-associated biases in this article. Of 137 first-time lumbar fusions for spondylolisthesis, 83 patients underwent PLF and 54 underwent PLIF/TLIF. The average time to reoperation was 3.5 years. The mean QALY over 3.5 years was 2.81 in the PLF cohort versus 2.66 in the PLIFo/TLIF cohort (p=.110). The mean 3.5-year costs of $54,827.05 after index interbody fusion were

Biometric image enhancement using decision rule based image fusion techniques

NASA Astrophysics Data System (ADS)

Sagayee, G. Mary Amirtha; Arumugam, S.

2010-02-01

Introducing biometrics into information systems may result in considerable benefits. Most of the researchers confirmed that the finger print is widely used than the iris or face and more over it is the primary choice for most privacy concerned applications. For finger prints applications, choosing proper sensor is at risk. The proposed work deals about, how the image quality can be improved by introducing image fusion technique at sensor levels. The results of the images after introducing the decision rule based image fusion technique are evaluated and analyzed with its entropy levels and root mean square error.

A Narrative Review of Lumbar Fusion Surgery With Relevance to Chiropractic Practice.

PubMed

Daniels, Clinton J; Wakefield, Pamela J; Bub, Glenn A; Toombs, James D

2016-12-01

The purpose of this narrative review was to describe the most common spinal fusion surgical procedures, address the clinical indications for lumbar fusion in degeneration cases, identify potential complications, and discuss their relevance to chiropractic management of patients after surgical fusion. The PubMed database was searched from the beginning of the record through March 31, 2015, for English language articles related to lumbar fusion or arthrodesis or both and their incidence, procedures, complications, and postoperative chiropractic cases. Articles were retrieved and evaluated for relevance. The bibliographies of selected articles were also reviewed. The most typical lumbar fusion procedures are posterior lumbar interbody fusion, anterior lumbar interbody fusion, transforaminal interbody fusion, and lateral lumbar interbody fusion. Fair level evidence supports lumbar fusion procedures for degenerative spondylolisthesis with instability and for intractable low back pain that has failed conservative care. Complications and development of chronic pain after surgery is common, and these patients frequently present to chiropractic physicians. Several reports describe the potential benefit of chiropractic management with spinal manipulation, flexion-distraction manipulation, and manipulation under anesthesia for postfusion low back pain. There are no published experimental studies related specifically to chiropractic care of postfusion low back pain. This article describes the indications for fusion, common surgical practice, potential complications, and relevant published chiropractic literature. This review includes 10 cases that showed positive benefits from chiropractic manipulation, flexion-distraction, and/or manipulation under anesthesia for postfusion lumbar pain. Chiropractic care may have a role in helping patients in pain who have undergone lumbar fusion surgery.

Sensor Fusion Techniques for Phased-Array Eddy Current and Phased-Array Ultrasound Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arrowood, Lloyd F.

Sensor (or Data) fusion is the process of integrating multiple data sources to produce more consistent, accurate and comprehensive information than is provided by a single data source. Sensor fusion may also be used to combine multiple signals from a single modality to improve the performance of a particular inspection technique. Industrial nondestructive testing may utilize multiple sensors to acquire inspection data depending upon the object under inspection and the anticipated types of defects that can be identified. Sensor fusion can be performed at various levels of signal abstraction with each having its strengths and weaknesses. A multimodal data fusionmore » strategy first proposed by Heideklang and Shokouhi that combines spatially scattered detection locations to improve detection performance of surface-breaking and near-surface cracks in ferromagnetic metals is shown using a surface inspection example and is then extended for volumetric inspections. Utilizing data acquired from an Olympus Omniscan MX2 from both phased array eddy current and ultrasound probes on test phantoms, single and multilevel fusion techniques are employed to integrate signals from the two modalities. Preliminary results demonstrate how confidence in defect identification and interpretation benefit from sensor fusion techniques. Lastly, techniques for integrating data into radiographic and volumetric imagery from computed tomography are described and results are presented.« less

Rational decision making in a wide scenario of different minimally invasive lumbar interbody fusion approaches and devices.

PubMed

Pimenta, Luiz; Tohmeh, Antoine; Jones, David; Amaral, Rodrigo; Marchi, Luis; Oliveira, Leonardo; Pittman, Bruce C; Bae, Hyun

2018-03-01

With the proliferation of a variety of modern MIS spine surgery procedures, it is mandatory that the surgeon dominate all aspects involved in surgical indication. The information related to the decision making in patient selection for specific procedures is mandatory for surgical success. The objective of this study is to present decision-making criteria in minimally invasive surgery (MIS) selection for a variety of patients and pathologies. In this article, practicing surgeons who specialize in various MIS approaches for spinal fusion were engaged to provide expert opinion and literature review on decision making criteria for several MIS procedures. Pros, cons, relative limitations, and case examples are provided for patient selection in treatment with MIS posterolateral fusion (MIS-PLF), mini anterior lumbar interbody fusion (mini-ALIF), lateral interbody fusion (LLIF), MIS posterior lumbar interbody fusion (MIS-PLIF) and MIS transforaminal lumbar interbody fusion (MIS-TLIF). There is a variety of aspects to consider when deciding which modern MIS surgical approach is most appropriate to use based on patient and pathologic characteristics. The surgeon must adapt them to the characteristic of each type of patients, helping them to choose the most effective and efficient therapeutic option for each case.

Cervical hybrid arthroplasty with 2 unique fusion techniques.

PubMed

Cardoso, Mario J; Mendelsohn, Audra; Rosner, Michael K

2011-07-01

Multilevel cervical arthroplasty achieved using the Prestige ST disc can be challenging and often unworkable. An alternative to this system is a hybrid technique composed of alternating total disc replacements (TDRs) and fusions. In the present study, the authors review the safety and radiological outcomes of cervical hybrid arthroplasty in which the Prestige ST disc is used in conjunction with 2 unique fusion techniques. After obtaining institutional review board approval, the authors completed a retrospective review of all hybrid cervical constructs in which the Prestige ST disc was used between August 2007 and November 2009 at the Walter Reed Army Medical Center. A Prestige ST total disc replacement was performed in 119 patients. Thirty-one patients received a hybrid construct defined as a TDR and fusion (TDR-anterior cervical decompression and fusion [ACDF]) or as 2 TDRs separated by a fusion (TDR-ACDF-TDR). A resorbable plate and graft system (Mystique) or stand-alone interbody spacer (Prevail) was implanted at the fusion levels. Plain radiographs were compared and evaluated for cervical lordosis, range of motion, implant complications, development of adjacent-level disease, and pseudarthrosis. In addition, charts were reviewed for clinical complications related to the index surgery. Thirty-one patients (18 men and 13 women; mean age 50 years, range 32-74 years) received a hybrid construct. All patients were diagnosed with radiculopathy and/or myelopathy. Twenty-four patients received a 2-level and 7 a 3-level hybrid construct. In 2 patients in whom a 2-level hybrid construct was implanted, a noncontiguous TDR was also performed. The mean clinical and radiological follow-up duration was 18 months. There was no significant difference in preoperative (19.3° ± 13.3°) and postoperative (19.7° ± 10.5°) cervical lordosis (p = 0.48), but there was a significant decrease in range in motion (from 50.0° ± 11.8° to 38.9° ± 12.7°) (p = 0.003). There were no

Techniques of lumbar-sacral spine fusion in spondylosis: systematic literature review and meta-analysis of randomized clinical trials.

PubMed

Umeta, Ricardo S G; Avanzi, Osmar

2011-07-01

Spine fusions can be performed through different techniques and are used to treat a number of vertebral pathologies. However, there seems to be no consensus regarding which technique of fusion is best suited to treat each distinct spinal disease or group of diseases. To study the effectiveness and complications of the different techniques used for spinal fusion in patients with lumbar spondylosis. Systematic literature review and meta-analysis. Randomized clinical studies comparing the most commonly performed surgical techniques for spine fusion in lumbar-sacral spondylosis, as well as those reporting patient outcome were selected. Identify which technique, if any, presents the best clinical, functional, and radiographic outcome. Systematic literature review and meta-analysis based on scientific articles published and indexed to the following databases: PubMed (1966-2009), Cochrane Collaboration-CENTRAL, EMBASE (1980-2009), and LILACS (1982-2009). The general search strategy focused on the surgical treatment of patients with lumbar-sacral spondylosis. Eight studies met the inclusion criteria and were selected with a total of 1,136 patients. Meta-analysis showed that patients who underwent interbody fusion presented a significantly smaller blood loss (p=.001) and a greater rate of bone fusion (p=.02). Patients submitted to fusion using the posterolateral approach had a significantly shorter operative time (p=.007) and less perioperative complications (p=.03). No statistically significant difference was found for the other studied variables (pain, functional impairment, and return to work). The most commonly used techniques for lumbar spine fusion in patients with spondylosis were interbody fusion and posterolateral approach. Both techniques were comparable in final outcome, but the former presented better rates of fusion and the latter the less complications. Copyright © 2011 Elsevier Inc. All rights reserved.

Titanium vs. polyetheretherketone (PEEK) interbody fusion: Meta-analysis and review of the literature.

PubMed

Seaman, Scott; Kerezoudis, Panagiotis; Bydon, Mohamad; Torner, James C; Hitchon, Patrick W

2017-10-01

Spinal interbody fusion is a standard and accepted method for spinal fusion. Interbody fusion devices include titanium (Ti) and polyetheretherketone (PEEK) cages with distinct biomechanical properties. Titanium and PEEK cages have been evaluated in the cervical and lumbar spine, with conflicting results in bony fusion and subsidence. Using Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines, we reviewed the available literature evaluating Ti and PEEK cages to assess subsidence and fusion rates. Six studies were included in the analysis, 3 of which were class IV evidence, 2 were class III, and 1 was class II. A total of 410 patients (Ti-228, PEEK-182) and 587 levels (Ti-327, PEEK-260) were studied. Pooled mean age was 50.8years in the Ti group, and 53.1years in the PEEK group. Anterior cervical discectomy was performed in 4 studies (395 levels) and transforaminal interbody fusion in 2 studies (192 levels). No statistically significant difference was found between groups with fusion (OR 1.16, 95% C.I 0.59-2.89, p=0.686, I 2 =49.7%) but there was a statistically significant the rate of subsidence with titanium (OR 3.59, 95% C.I 1.28-10.07, p=0.015, I 2 =56.9%) at last follow-up. Titanium and PEEK cages are associated with a similar rate of fusion, but there is an increased rate of subsidence with titanium cage. Future prospective randomized controlled trials are needed to further evaluate these cages using surgical and patient-reported outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

A review of data fusion techniques.

PubMed

Castanedo, Federico

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.

Lumbar lordosis restoration following single-level instrumented fusion comparing 4 commonly used techniques.

PubMed

Dimar, John R; Glassman, Steven D; Vemuri, Venu M; Esterberg, Justin L; Howard, Jennifer M; Carreon, Leah Y

2011-11-09

A major sequelae of lumbar fusion is acceleration of adjacent-level degeneration due to decreased lumbar lordosis. We evaluated the effectiveness of 4 common fusion techniques in restoring lordosis: instrumented posterolateral fusion, translumbar interbody fusion, anteroposterior fusion with posterior instrumentation, and anterior interbody fusion with lordotic threaded (LT) cages (Medtronic Sofamor Danek, Memphis, Tennessee). Radiographs were measured preoperatively, immediately postoperatively, and a minimum of 6 months postoperatively. Parameters measured included anterior and posterior disk space height, lumbar lordosis from L3 to S1, and surgical level lordosis.No significant difference in demographics existed among the 4 groups. All preoperative parameters were similar among the 4 groups. Lumbar lordosis at final follow-up showed no difference between the anteroposterior fusion with posterior instrumentation, translumbar interbody fusion, and LT cage groups, although the posterolateral fusion group showed a significant loss of lordosis (-10°) (P<.001). Immediately postoperatively and at follow-up, the LT cage group had a significantly greater amount of lordosis and showed maintenance of anterior and posterior disk space height postoperatively compared with the other groups. Instrumented posterolateral fusion produces a greater loss of lordosis compared with anteroposterior fusion with posterior instrumentation, translumbar interbody fusion, and LT cages. Maintenance of lordosis and anterior and posterior disk space height is significantly better with anterior interbody fusion with LT cages. Copyright 2011, SLACK Incorporated.

New Optimal Needle Entry Angle for Cervical Transforaminal Epidural Steroid Injections: A Retrospective Study

PubMed Central

Karm, Myong-Hwan; Park, Jun Young; Kim, Doo Hwan; Cho, Hyun-Seok; Lee, Jae-Young; Kwon, Koo; Suh, Jeong Hun

2017-01-01

Objective: A cervical epidural steroid injection is one of the most commonly performed interventions to manage chronic neck pain and cervical radiculopathy. Despite its many severe complications, cervical transforaminal epidural steroid injection (CTFESI) is a clinically necessary modality for managing neck pain and cervical radiculopathy. We aimed in this study to find a safer optimal needle entry angle to decrease the chance of an accidental vertebral artery (VA) puncture even with a proper needle entry angle and to visualize the target of the needle tip. Methods: This retrospective study included 312 patients with neck pain or cervical radiculopathy who had undergone magnetic resonance imaging scans for diagnosis and treatment. The first line was drawn from the midpoint of the two articular pillars and passed through the exact midline of the spinous process. The second line was drawn parallel to the ventral lamina line (conventional transforaminal approach line, CTAL). The third line was drawn parallel to the ventral margin at the midpoint of the superior articular process's ventral border (new transforaminal approach line, NTAL). The angle of intersection between the midline and CTAL versus with NTAL were measured from both sides (right and left) at C5-6, C6-7, and C7-T1 levels. Also, the distance of CTAL and NTAL from VA were measured from both sides at each level. We examined whether the CTAL and NTAL would penetrate the ipsilateral VA, internal carotid artery (ICA), and internal jugular vein (IJV). Results: There were significant differences between CTAL and NTAL angles at all levels (P < 0.001). There were significant differences between the distance of CTAL and NTAL from VA at all levels (P < 0.001). There were also significant differences between the observed frequency of CTAL and NTAL that would penetrate the major ipsilateral vessel (VA, ICA, and IJV) on all levels and sides (P < 0.001~0.030). Conclusion: The angle of NTAL (approximately 70°) is safer

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. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years.

PubMed

Parker, Scott L; Adogwa, Owoicho; Bydon, Ali; Cheng, Joseph; McGirt, Matthew J

2012-07-01

Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spondylolisthesis allows for surgical treatment of back and leg pain while theoretically minimizing tissue injury and accelerating overall recovery. Although the authors of previous studies have demonstrated shorter length of hospital stay and reduced blood loss with MIS versus open-TLIF, short- and long-term outcomes have been similar. No studies to date have evaluated the comprehensive health care costs associated with TLIF procedures or assessed the cost-utility of MIS- versus open-TLIF. As such, we set out to assess previously unstudied end points of health care cost and cost-utility associated with MIS- versus open-TLIF. Thirty patients undergoing MIS-TLIF (n=15) or open-TLIF (n=15) for grade I degenerative spondylolisthesis associated back and leg pain were prospectively studied. Total back-related medical resource use, missed work, and health-state values (quality-adjusted life years [QALYs], calculated from EQ-5D with U.S. valuation) were assessed after two-year follow-up. Two-year resource use was multiplied by unit costs on the basis of Medicare national allowable payment amounts (direct cost) and work-day losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Difference in mean total cost per QALY gained for MIS- versus open-TLIF was assessed as incremental cost-effectiveness ratio (ICER: COSTmis-COSTopen/QALYmis-QALYopen). MIS versus open-TLIF cohorts were similar at baseline. By two years postoperatively, patients undergoing MIS- versus open-TLIF reported similar mean QALYs gained (0.50 vs. 0.41, P=0.17). Mean total two-year cost of MIS- and open-TLIF was $35,996 and $44,727, respectively. The $8,731 two-year cost savings of MIS- versus open-TLIF did not reach statistical significance (P=0.18) for this sample size. Although our limited sample size prevented statistical significance, MIS- versus open-TLIF was associated with reduced costs over

Transforaminal lumbar interbody graft placement using an articulating delivery arm facilitates increased segmental lordosis with superior anterior and midline graft placement.

PubMed

Shau, David N; Parker, Scott L; Mendenhall, Stephen K; Zuckerman, Scott L; Godil, Saniya S; Devin, Clinton J; McGirt, Matthew J

2015-05-01

Transforaminal lumbar interbody fusion (TLIF) is a frequently performed method of lumbar arthrodesis in patients failing medical management of back and leg pain. Accurate placement of the interbody graft and restoration of lordosis has been shown to be crucial when performing lumbar fusion procedures. We performed a single-surgeon, prospective, randomized study to determine whether a novel articulating versus traditional straight graft delivery arm system allows for superior graft placement and increased lordosis for single-level TLIF. Thirty consecutive patients undergoing single-level TLIF were included and prospectively randomized to one of the 2 groups (articulated vs. straight delivery arm system). Three radiographic characteristics were evaluated at 6-week follow-up: (1) degree of segmental lumbar lordosis at the fused level; (2) the percent anterior location of the interbody graft in disk space; and (3) the distance (mm) off midline of the interbody graft placement. Randomization yielded 16 patients in the articulated delivery arm cohort and 14 in the straight delivery arm cohort. The articulating delivery arm system yielded an average of 14.7-degree segmental lordosis at fused level, 35% anterior location, and 3.6 mm off midline. The straight delivery arm system yielded an average of 10.7-degree segmental lordosis at fused level, 46% anterior location, and 7.0 mm off midline. All 3 comparisons were statistically significant (P<0.05). The study suggests that an articulating delivery arm system facilitates superior anterior and midline TLIF graft placement allowing for increased segmental lordosis compared with a traditional straight delivery arm system.

Comparison of incidence of intravascular injections during transforaminal epidural steroid injection using different needle types

PubMed Central

Lee, Yong Ho

2014-01-01

Background Infrequent but serious complications of transforaminal epidural steroid injection (TFESI) occur due to inadvertent intravascular injections. A few studies reported that the different needle types can influence on the occurrences of intravascular incidence in TFESI. This study prospectively evaluated whether short-bevel needle can reduce the incidences of intravascular injection of TFESI compared to long-bevel needles. Methods From March 2013 to December 2013, 239 consecutive patients were enrolled and received 249 fluoroscopically guided TFESI using the classic technique. Confirmation of intravascular spread was done initially with real time fluoroscopy and then with digital subtraction angiography method in a same patient. Injection technique for TFESI was the same for both short-bevel and long-bevel needle types. Results The incidences of intravascular injections with the long-bevel and short-bevel needles were 15.0% (21/140) and 9.2% (4/140), respectively. More than half of intravascular injections occurred simultaneously with epidural injections (8.0%, 20/249). There were no statistically significant differences between the long-bevel and the short-bevel needles in the rates of intravascular injections (P = 0.17). Conclusions Short-bevel needles did not demonstrate any benefits in reducing the incidence of intravascular injection. PMID:25302096

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

PubMed

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

2015-04-01

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.

[Efficacy of transforaminal lumbar epidural steroid injections in patients with lumbar radiculopathy].

PubMed

Çetin, Mehmet Fatih; Karaman, Haktan; Ölmez Kavak, Gönül; Tüfek, Adnan; Baysal Yildirim, Zeynep

2012-01-01

This study looks into the efficacy and safety of the transforaminal lumbar epidural steroid injection (TLESI) applied to patients with radiculopathy due to lumbar disk herniation. The patients' files which were applied TLESI, were retrospectively scanned. Patients who did not respond to one-month conservative treatment and who were detected to have bulging or protruding lumbar disk herniation as a result of imaging methods were included in the study. All applications were performed with C-arm fluoroscopy under local anesthesia by outpatient method. In all cases, a mix of 80 mg triamsinolone and 0.25% bupivacaine, was transforaminally injected to the anterior epidural area. Initial VAS pain scores were compared with the values of the 1, 3 and 6th months after the application. Patient satisfaction was determined through scoring. Furthermore, early and late term complications were collected for evaluation. A total of 222 patients were administered TLESI 460 times (average: 2.1, repeat interval: 1-6 times). The applications were carried out most frequently at the levels of L4-L5 and L5-S1. While the initial VAS score average was 8.2±0.7, after TLESI, it was 5.0±1.6, 4.8±1.5 and 5.1±1.5 in the 1, 3 and 6th months, respectively. 63.9% of the patients (n=142) defined the treatment as 'good and excellent'. No major complications were experienced and the overall minor complication rate was 11.1%. It was seen that TLESI was an efficient and safe method in the short and medium term.

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.

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

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

PubMed

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

2016-02-05

Evaluate the efficacy of using the SIGN nail for instrumented knee fusion. 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. 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. 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.

Effect of cage design, supplemental posterior instrumentation and approach on primary stability of a lumbar interbody fusion - A biomechanical in vitro study.

PubMed

Schmoelz, Werner; Sandriesser, Sabrina; Loebl, Oded; Bauer, Marlies; Krappinger, Dietmar

2017-10-01

There are various techniques and approaches for lumbar interbody fusion differing in access, cage type and type of supplemental posterior instrumentation. While a transforaminal access usually includes a hemifacetectomy, the facet joint can be preserved with a more lateral extraforaminal access. The supplemental posterior instrumentation required for both fusion techniques is still debated. The purpose of the present study was to compare primary stability of the two accesses for two different cage types with none, unilateral and bilateral supplemental posterior instrumentation. Six monosegmental lumbar functional spinal units (FSUs) were included in each of the two groups, and subjected to a flexibility test. As cages, a newly designed cage was compared to a standard cage in the following states: (a) native, (b) stand-alone cage, (c) bilateral internal fixator, (d) unilateral internal fixator, (e) unilateral facetectomy+bilateral internal fixator, (f) unilateral facetectomy+unilateral internal fixator and (g) unilateral facetectomy with stand-alone cage. For comparison the range of motion was normalized to the native state and the effects of the facetectomy, cage type, and supplemental instrumentation was compared. Within the subject comparison showed a significantly higher flexibility for the unilateral facetectomy in all motion directions (p<0.001). In between subject comparison showed a significant effect of cage type on flexibility in flexion/extension (p=0.002) and lateral bending (p=0.028) but not in axial rotation (p=0.322). The type of supplemental posterior fixation had a significant effect on the flexibility in all motion directions (stand-alone>unilateral fixator>bilateral fixator). Cage design and approach type are affecting the primary stability of lumbar interbody fusion procedures while the type of posterior instrumentation is the most influencing factor. Copyright © 2017 Elsevier Ltd. All rights reserved.

Application of data fusion techniques and technologies for wearable health monitoring.

PubMed

King, Rachel C; Villeneuve, Emma; White, Ruth J; Sherratt, R Simon; Holderbaum, William; Harwin, William S

2017-04-01

Technological advances in sensors and communications have enabled discrete integration into everyday objects, both in the home and about the person. Information gathered by monitoring physiological, behavioural, and social aspects of our lives, can be used to achieve a positive impact on quality of life, health, and well-being. Wearable sensors are at the cusp of becoming truly pervasive, and could be woven into the clothes and accessories that we wear such that they become ubiquitous and transparent. To interpret the complex multidimensional information provided by these sensors, data fusion techniques are employed to provide a meaningful representation of the sensor outputs. This paper is intended to provide a short overview of data fusion techniques and algorithms that can be used to interpret wearable sensor data in the context of health monitoring applications. The application of these techniques are then described in the context of healthcare including activity and ambulatory monitoring, gait analysis, fall detection, and biometric monitoring. A snap-shot of current commercially available sensors is also provided, focusing on their sensing capability, and a commentary on the gaps that need to be bridged to bring research to market. Copyright © 2017. Published by Elsevier Ltd.

Enhanced EDX images by fusion of multimodal SEM images using pansharpening techniques.

PubMed

Franchi, G; Angulo, J; Moreaud, M; Sorbier, L

2018-01-01

The goal of this paper is to explore the potential interest of image fusion in the context of multimodal scanning electron microscope (SEM) imaging. In particular, we aim at merging the backscattered electron images that usually have a high spatial resolution but do not provide enough discriminative information to physically classify the nature of the sample, with energy-dispersive X-ray spectroscopy (EDX) images that have discriminative information but a lower spatial resolution. The produced images are named enhanced EDX. To achieve this goal, we have compared the results obtained with classical pansharpening techniques for image fusion with an original approach tailored for multimodal SEM fusion of information. Quantitative assessment is obtained by means of two SEM images and a simulated dataset produced by a software based on PENELOPE. © 2017 The Authors Journal of Microscopy © 2017 Royal Microscopical Society.

The biomechanics of a multilevel lumbar spine hybrid using nucleus replacement in conjunction with fusion.

PubMed

Dahl, Michael C; Ellingson, Arin M; Mehta, Hitesh P; Huelman, Justin H; Nuckley, David J

2013-02-01

Degenerative disc disease is commonly a multilevel pathology with varying deterioration severity. The use of fusion on multiple levels can significantly affect functionality and has been linked to persistent adjacent disc degeneration. A hybrid approach of fusion and nucleus replacement (NR) has been suggested as a solution for mildly degenerated yet painful levels adjacent to fusion. To compare the biomechanical metrics of different hybrid implant constructs, hypothesizing that an NR+fusion hybrid would be similar to a single-level fusion and perform more naturally compared with a two-level fusion. A cadaveric in vitro repeated-measures study was performed to evaluate a multilevel lumbar NR+fusion hybrid. Eight cadaveric spines (L3-S1) were tested in a Spine Kinetic Simulator (Instron, Norwood, MA, USA). Pure moments of 8 Nm were applied in flexion/extension, lateral bending, and axial rotation as well as compression loading. Specimens were tested intact; fused (using transforaminal lumbar interbody fusion instrumentation with posterior rods) at L5-S1; with a nuclectomy at L4-L5 including fusion at L5-S1; with NR at L4-L5 including fusion at L5-S1; and finally with a two-level fusion spanning L4-S1. Repeated-measures analysis of variance and corrected t tests were used to statistically compare outcomes. The NR+fusion hybrid and single-level fusion exhibited no statistical differences for range of motion (ROM), stiffness, neutral zone, and intradiscal pressure in all loading directions. Compared with two-level fusion, the hybrid affords the construct 41.9% more ROM on average. Two-level fusion stiffness was statistically higher than all other constructs and resulted in significantly lower ROM in flexion, extension, and lateral bending. The hybrid construct produced approximately half of the L3-L4 adjacent-level pressures as the two-level fusion case while generating similar pressures to the single-level fusion case. These data portend more natural functional

Clinical experiences of performing transforaminal balloon adhesiolysis in patients with failed back surgery syndrome: two cases report

PubMed Central

Hwang, Bo-Young; Ko, Hong-Seok; Suh, Jeong-Hun; Shin, Jin-Woo; Leem, Jeong-Gill

2014-01-01

Epidural fibrosis is a contributing factor to the persistent pain that is associated with failed back surgery syndrome (FBSS) and other pathophysiologies, particularly as it inhibits the passage of regional medications to areas responsible for pain. Therefore, effective mechanical detachment of epidural fibrosis can contribute to pain reduction and improve function in FBSS patients. In this report, we describe the successful treatment of FBSS patients with epidural adhesiolysis using a Fogarty catheter via the transforaminal approach. PMID:24624278

The effect of bench model fidelity on fluoroscopy-guided transforaminal epidural injection training: a randomized control study.

PubMed

Gonzalez-Cota, Alan; Chiravuri, Srinivas; Stansfield, R Brent; Brummett, Chad M; Hamstra, Stanley J

2013-01-01

The purpose of this study was to determine whether high-fidelity simulators provide greater benefit than low-fidelity models in training fluoroscopy-guided transforaminal epidural injection. This educational study was a single-center, prospective, randomized 3-arm pretest-posttest design with a control arm. Eighteen anesthesia and physical medicine and rehabilitation residents were instructed how to perform a fluoroscopy-guided transforaminal epidural injection and assessed by experts on a reusable injectable phantom cadaver. The high- and low-fidelity groups received 30 minutes of supervised hands-on practice according to group assignment, and the control group received 30 minutes of didactic instruction from an expert. We found no differences at posttest between the high- and low-fidelity groups on global ratings of performance (P = 0.17) or checklist scores (P = 0.81). Participants who received either form of hands-on training significantly outperformed the control group on both the global rating of performance (control vs low-fidelity, P = 0.0048; control vs high-fidelity, P = 0.0047) and the checklist (control vs low-fidelity, P = 0.0047; control vs high-fidelity, P = 0.0047). Training an epidural procedure using a low-fidelity model may be equally effective as training on a high-fidelity model. These results are consistent with previous research on a variety of interventional procedures and further demonstrate the potential impact of simple, low-fidelity training models.

Effects of Psoas Muscle Thickness on Outcomes of Lumbar Fusion Surgery.

PubMed

Verla, Terence; Adogwa, Owoicho; Elsamadicy, Aladine; Moreno, Jessica R; Farber, Harrison; Cheng, Joseph; Bagley, Carlos A

2016-03-01

Lumbar arthrodesis is a surgical option for treatment of lumbar pathologies. Stability of the spinal construct partly depends on load-bearing support from back muscles. Despite the role of the psoas muscle in upright spinal stabilization, data describing its clinical significance are scarce. We evaluated the effects of the psoas muscle thickness on outcomes after lumbar fusion surgery. A retrospective review was performed of hospital records (2007-2013) of adult patients undergoing lumbar fusion surgery. Patients ≥ 18 years old who had undergone ≥ 1 level of lumbar fusion with available preoperative magnetic resonance imaging scans and at least 1 year of follow-up were included. Axial psoas muscle thickness was measured at each lumbar intervertebral space. Psoas muscle thickness at each vertebral level was compared between patients with and without the occurrence of specific clinical outcomes. There were 257 patients included. The average age was 58.15 years; about 45% of patients were men. Most of the patients underwent a transforaminal interbody fusion surgery (58.4%). The average psoas muscle thickness ranged from 11.49 mm at L1-2 to 36.51 mm at L4-5. Patients with postoperative hip flexor weakness and increased time to ambulation had significantly smaller psoas muscle thickness. Also, patients with >50% improvement in visual analog scale pain score had significantly greater psoas muscle thickness. This study shows that the psoas muscle can be beneficial in overall postoperative rehabilitation with early ambulation and greater improvement in functional outcomes. Given the role of the psoas muscle in spinal stabilization, the effect of psoas muscle thickness on postoperative functional outcomes warrants further investigation. Copyright © 2016 Elsevier Inc. All rights reserved.

Isocentric Navigation of Percutaneous Endoscopic Transforaminal Discectomy at the L5/S1 Level in Difficult Puncture Cases: A Technical Note.

PubMed

Fan, Guoxin; Wang, Teng; Hu, Shuo; Guan, Xiaofei; Gu, Xin; He, Shisheng

2017-05-01

Accurate puncture during percutaneous transforaminal endoscopic discectomy at the L5/S1 level in cases with high iliac crest and narrow foramen were difficult, even though the difficulties of foraminoplasty could be overcome by advanced instruments like reamers. The report aimed to describe an isocentric navigation technique with a definite pathway in difficult puncture cases at the L5/S1 level. Technical note. Difficult punctures were defined as over 10 punctures of the needle before obtaining an ideal puncture location by senior surgeons with experience of over 500 percutaneous endoscopic transforaminal discectomy (PETD) cases. A total of 124 punctures were recorded in 11 difficult puncture cases at the L5/S1 level. A definite pathway was created by an isocentric navigation theory, which was based on a surface locator and an arch-guided device. The surface locator was used to rapidly and accurately identify the puncture target with the recognition of the surrounding rods under fluoroscopy. The arch-guided device can ensure that the puncture target always remains at the center of a virtual sphere. We recorded the puncture times, fluoroscopy exposure times, radiation exposure time, operative time, visual analog scale (VAS) score, Japanese Orthopeadic Association (JOA) score, and patient satisfaction. The average puncture times were significantly reduced to 1.27 with the arch-guided device compared with conventional puncture methods (P < 0.05). The average operative time was 90.09 ± 11.00 minutes and the fluoroscopy times were 53.36 ± 5.85. The radiation exposure time was 50.91 ± 5.20 seconds. VAS score of leg and back pain, as well as JOA score, were all significantly improved after surgery (P < 0.05). The excellent and good rate of satisfaction was 90.91%. No major complications, including cerebral fluid leakage, surgical infection, and postoperative nerve root injury, were recorded in this small sample. This was a small-sample study with a short follow-up. The

Green and Fast Laser Fusion Technique for Bulk Silicate Rock Analysis by Laser Ablation-Inductively Coupled Plasma Mass Spectrometry.

PubMed

Zhang, Chenxi; Hu, Zhaochu; Zhang, Wen; Liu, Yongsheng; Zong, Keqing; Li, Ming; Chen, Haihong; Hu, Shenghong

2016-10-18

Sample preparation of whole-rock powders is the major limitation for their accurate and precise elemental analysis by laser ablation inductively-coupled plasma mass spectrometry (ICPMS). In this study, a green, efficient, and simplified fusion technique using a high energy infrared laser was developed for major and trace elemental analysis. Fusion takes only tens of milliseconds for each sample. Compared to the pressed pellet sample preparation, the analytical precision of the developed laser fusion technique is higher by an order of magnitude for most elements in granodiorite GSP-2. Analytical results obtained for five USGS reference materials (ranging from mafic to intermediate to felsic) using the laser fusion technique generally agree with recommended values with discrepancies of less than 10% for most elements. However, high losses (20-70%) of highly volatile elements (Zn and Pb) and the transition metal Cu are observed. The achieved precision is within 5% for major elements and within 15% for most trace elements. Direct laser fusion of rock powders is a green and notably simple method to obtain homogeneous samples, which will significantly accelerate the application of laser ablation ICPMS for whole-rock sample analysis.

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.

Is a drain tube necessary for minimally invasive lumbar spine fusion surgery?

PubMed

Hung, Pei-I; Chang, Ming-Chau; Chou, Po-Hsin; Lin, Hsi-Hsien; Wang, Shih-Tien; Liu, Chien-Lin

2017-03-01

This study aimed to evaluate if closed suction wound drainage is necessary in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF). This is a prospective randomized clinical study. Fifty-six patients who underwent MIS TLIF were randomly divided into groups A (with a closed suction wound drainage) and B (without tube drainage). Surgical duration, intraoperative blood loss, timing of ambulation, length of hospital stay and complications were recorded. Patients were followed up for an average of 25.3 months. Clinical outcome was assessed using the Oswestry disability index and visual analogue scale (VAS). Fusion rate was classified with the Bridwell grading system, based on plain radiograph. Both groups had similar patient demographics. The use of drains had no significant influence on perioperative parameters including operative time, estimated blood loss, length of stay and complications. Patients in group B started ambulation 1 day earlier than patients in group A (p < 0.001). Clinical outcomes were comparable between group A and group B. A drain tube can lead to pain, anxiety and discomfort during the postoperative period. We conclude that drain tubes are not necessary for MIS TLIF. Patients without drains had the benefit of earlier ambulation than those with drains.

Quality evaluation of different fusion techniques applied on Worldview-2 data

NASA Astrophysics Data System (ADS)

Vaiopoulos, Aristides; Nikolakopoulos, Konstantinos G.

2015-10-01

In the current study a Worldview-2 image was used for fusion quality assessment. The bundle image was collected on July 2014 over Araxos area in Western Peloponnese. Worldview-2 is the first satellite that collects at the same time a panchromatic (Pan) image and 8 band multispectral (MS) image. The Pan data have a spatial resolution of 0.46m while the MS data have a spatial resolution of 1.84m. In contrary to the respective Pan band of Ikonos and Quickbird that range between 0.45 and 0.90 micrometers the Worldview Pan band is narrower and ranges between 0.45 and 0.8 micrometers. The MS bands include four conventional visible and near-infrared bands common to multispectral satellites like Ikonos Quickbird, Geoeye Landsat-7 etc., and four new bands. Thus, it is quite interesting to investigate the assessment of commonly used fusion algorithms with Worldview-2 data. Twelve fusion techniques and more especially the Ehlers, Gram-Schmidt, Color Normalized, High Pass Filter, Hyperspherical Color Space, Local Mean Matching (LMM), Local Mean and Variance Matching (LMVM), Modified IHS (ModIHS), Pansharp, Pansharp2, PCA and Wavelet were used for the fusion of Worldview-2 panchromatic and multispectral data. The optical result, the statistical parameters and different quality indexes such as ERGAS, Q and entropy difference were examined and the results are presented. The quality control was evaluated both in spectral and spatial domain.

Radiographic and Clinical Outcome of Silicate-substituted Calcium Phosphate (Si-CaP) Ceramic Bone Graft in Spinal Fusion Procedures.

PubMed

Alimi, Marjan; Navarro-Ramirez, Rodrigo; Parikh, Karishma; Njoku, Innocent; Hofstetter, Christoph P; Tsiouris, Apostolos J; Härtl, Roger

2017-07-01

Retrospective cohort study. To evaluate the radiographic and clinical outcome of silicate-substituted calcium phosphate (Si-CaP), utilized as a graft substance in spinal fusion procedures. Specific properties of Si-CaP provide the graft with negative surface charge that can result in a positive effect on the osteoblast activity and neovascularization of the bone. This study included those patients who underwent spinal fusion procedures between 2007 and 2011 in which Si-CaP was used as the only bone graft substance. Fusion was evaluated on follow-up CT scans. Clinical outcome was assessed using Oswestry Disability Index, Neck Disability Index, and the visual analogue scale (VAS) for back, leg, neck, and arm pain. A total of 234 patients (516 spinal fusion levels) were studied. Surgical procedures consisted of 57 transforaminal lumbar interbody fusion, 49 anterior cervical discectomy and fusion, 44 extreme lateral interbody fusion, 30 posterior cervical fusions, 19 thoracic fusion surgeries, 17 axial lumbar interbody fusions, 16 combined anterior and posterior cervical fusions, and 2 anterior lumbar interbody fusion. At a mean radiographic follow-up of 14.2±4.3 months, fusion was found to be present in 82.9% of patients and 86.8% of levels. The highest fusion rate was observed in the cervical region. At the latest clinical follow-up of 21.7±14.2 months, all clinical outcome parameters showed significant improvement. The Oswestry Disability Index improved from 45.6 to 13.3 points, Neck Disability Index from 40.6 to 29.3, VAS back from 6.1 to 3.5, VAS leg from 5.6 to 2.4, VAS neck from 4.7 to 2.7, and VAS arm from 4.1 to 1.7. Of 7 cases with secondary surgical procedure at the index level, the indication for surgery was nonunion in 3 patients. Si-CaP is an effective bone graft substitute. At the latest follow-up, favorable radiographic and clinical outcome was observed in the majority of patients. Level-III.

Treatment of acute sciatica with transforaminal epidural corticosteroids and local anesthetic: design of a randomized controlled trial.

PubMed

Ter Meulen, Bastiaan C; Maas, Esther T; Vyas, Amrita; van der Vegt, Marinus; de Priester, Koo; de Boer, Michiel R; van Tulder, Maurits W; Weinstein, Henry C; Ostelo, Raymond W J G

2017-05-25

Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica. We will recruit a total of 264 patients with sciatica (<8 weeks) caused by a herniated disc, from two clinical sites. Participants are randomly assigned one of three study groups: 1) oral pain medication (control group), 2) oral pain medication and TESI-plus (intervention group one), 3) oral pain medication and transforaminal epidural injection (TEI) with Levobupivaine and saline solution (intervention group two). Primary outcomes are functional status (Roland-Morris Disability Questionnaire), pain intensity for both leg and back, (100 mm visual analogous scale (VAS)), and global perceived recovery (GPR, reported on a 7-point Likert scale, dichotomized into 'recovered' and 'not recovered'). The secondary outcomes are health-related quality of life (EQ5D-5 L) and patient satisfaction (7-point Likert scale). We will also collect information on healthcare utilization and costs, to perform an economic evaluation. All outcomes are measured at three and six weeks, three and six months after randomization. We defined a minimal clinically relevant difference between groups as a difference between both intervention groups and the control group of 20 points for pain (100-point VAS), four points for functional status (24-point RDQ) and a 20% difference on dichotomized GPR (recovered versus not recovered). A clinically

Knee fusion--a new technique using an old Belgian surgical approach and a new intramedullary nail.

PubMed

Alt, V; Seligson, D

2001-02-01

Knee arthrodesis is a useful procedure in difficult cases such as failed total knee arthroplasty, severe articular trauma, bone tumors, and infected knee joints. The most common techniques for knee fusion include external fixation and intramedullary nailing. Küntscher's nail is driven antegrade from the intertrochanteric region into the knee. We describe a new technique for knee arthrodesis using a new intramedullary nail and an old Belgian surgical approach to the knee joint published by Lambotte in 1913. This approach provides excellent exposure for the implantation of the nail by osteotomizing the patella vertically. The nail is implanted using HeyGroves method, whereby the nail is inserted retrograde into the femur and pulled distally anterograde into the tibia. We now use this technique as our standard procedure for knee fusion.

Effect of statin use on pain relief by transforaminal epidural steroid injection

PubMed Central

Aydın, Osman Nuri; Tasdemir, Banu; Galimberti, Fabrizio; Turan, Alparslan

2016-01-01

Aim To investigate the impact of statin use on response to fluoroscopy-assisted transforaminal anterior epidural steroid injection (TAESI). Methods Patients undergoing TAESI for low back pain were recruited and stratified according to statin use. Pain was evaluated with a visual analogue scale (VAS) before and at 1, 3, and 6 months after TAESI. Health-related quality-of-life was evaluated using the Short Form 36 (SF-36) questionnaire 6 months after TAESI. Results There were no significant differences in VAS scores after TAESI between statin users (n = 40) and statin nonusers (n = 253). The SF-36 subgroup: role limitations due to emotional problems score was significantly lower in statin users than statin nonusers. There were no significant between-group differences in any other SF-36 parameter. Conclusion Statin use had no effect on pain scores after TAESI. PMID:26912508

ALIF and total disc replacement versus 2-level circumferential fusion with TLIF: a prospective, randomized, clinical and radiological trial.

PubMed

Hoff, Eike K; Strube, Patrick; Pumberger, Matthias; Zahn, Robert K; Putzier, Michael

2016-05-01

Prospective, randomized trial. The treatment of degenerative disc disease (DDD) with two-level fusion has been associated with a reasonable rate of complications. The aim of the present study was to compare (Hybrid) stand-alone anterior lumbar interbody fusion (ALIF) at L5/S1 with total disc replacement at L4/5 (TDR) as an alternative surgical strategy to (Fusion) 2-level circumferential fusion employing transforaminal lumbar interbody fusion (TLIF) with transpedicular stabilization at L4-S1. A total of 62 patients with symptomatic DDD of segments L5/S1 (Modic ≥2°) and L4/5 (Modic ≤2°; positive discography) were enrolled; 31 were treated with Hybrid and 31 with Fusion. Preoperatively, at 0, 12, and a mean follow-up of 37 months, clinical (ODI, VAS) and radiological evaluations (plain/extension-flexion radiographs evaluated for implant failure, fusion, global and segmental lordosis, and ROM) were performed. In 26 of 31 Hybrid and 24 of 31 Fusion patients available at the final follow-up, we found a significant clinical improvement compared to preoperatively. Hybrid patients had significantly lower VAS scores immediately postoperatively and at follow-up compared to Fusion patients. The complication rates were low and similar between the groups. Lumbar lordosis increased in both groups. The increase was mainly located at L4-S1 in the Hybrid group and at L1-L4 in the Fusion group. Hybrid patients presented with increased ROM at L4/5 and L3/4, and Fusion patients presented with increased ROM at L3/4, with significantly greater ROM at L3/4 compared to Hybrid patients at follow-up. Hybrid surgery is a viable surgical alternative for the presented indication. Approach-related inferior trauma and the balanced restoration of lumbar lordosis resulted in superior clinical outcomes compared to two-level circumferential fusion with TLIF.

Lumbar degenerative spinal deformity: Surgical options of PLIF, TLIF and MI-TLIF

PubMed Central

Hey, Hwee Weng Dennis; Hee, Hwan Tak

2010-01-01

Degenerative disease of the lumbar spine is common in ageing populations. It causes disturbing back pain, radicular symptoms and lowers the quality of life. We will focus our discussion on the surgical options of posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for lumbar degenerative spinal deformities, which include symptomatic spondylolisthesis and degenerative scoliosis. Through a description of each procedure, we hope to illustrate the potential benefits of TLIF over PLIF. In a retrospective study of 53 ALIF/PLIF patients and 111 TLIF patients we found reduced risk of vessel and nerve injury in TLIF patients due to less exposure of these structures, shortened operative time and reduced intra-operative bleeding. These advantages could be translated to shortened hospital stay, faster recovery period and earlier return to work. The disadvantages of TLIF such as incomplete intervertebral disc and vertebral end-plate removal and potential occult injury to exiting nerve root when under experienced hands are rare. Hence TLIF remains the mainstay of treatment in degenerative deformities of the lumbar spine. However, TLIF being a unilateral transforaminal approach, is unable to decompress the opposite nerve root. This may require contralateral laminotomy, which is a fairly simple procedure. The use of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) to treat degenerative lumbar spinal deformity is still in its early stages. Although the initial results appear promising, it remains a difficult operative procedure to master with a steep learning curve. In a recent study comparing 29 MI-TLIF patients and 29 open TLIF, MI-TLIF was associated with longer operative time, less blood loss, shorter hospital stay, with no difference in SF-36 scores at six months and two years. Whether it can replace traditional TLIF as the surgery of choice for

Percutaneous full endoscopic lumbar foraminoplasty for adjacent level foraminal stenosis following vertebral intersegmental fusion in an awake and aware patient under local anesthesia: A case report.

PubMed

Yamashita, Kazuta; Higashino, Kosaku; Sakai, Toshinori; Takata, Yoichiro; Hayashi, Fumio; Tezuka, Fumitake; Morimoto, Masatoshi; Chikawa, Takashi; Nagamachi, Akihiro; Sairyo, Koichi

2017-01-01

Percutaneous endoscopic surgery for the lumbar spine has become established in the last decade. It requires only an 8 mm skin incision, causes minimal damage to the paravertebral muscles, and can be performed under local anesthesia. With the advent of improved equipment, in particular the high-speed surgical drill, the indications for percutaneous endoscopic surgery have expanded to include lumbar spinal canal stenosis. Transforaminal percutaneous endoscopic discectomy has been used to treat intervertebral stenosis. However, it has been reported that adjacent level disc degeneration and foraminal stenosis can occur following intervertebral segmental fusion. When this adjacent level pathology becomes symptomatic, additional fusion surgery is often needed. We performed minimally invasive percutaneous full endoscopic lumbar foraminoplasty in an awake and aware 50-year-old woman under local anesthesia. The procedure was successful with no complications. Her radiculopathy, including muscle weakness and leg pain due to impingement of the exiting nerve, improved after the surgery. J. Med. Invest. 64: 291-295, August, 2017.

Improving lung cancer prognosis assessment by incorporating synthetic minority oversampling technique and score fusion method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, Shiju; Qian, Wei; Guan, Yubao

2016-06-15

Purpose: This study aims to investigate the potential to improve lung cancer recurrence risk prediction performance for stage I NSCLS patients by integrating oversampling, feature selection, and score fusion techniques and develop an optimal prediction model. Methods: A dataset involving 94 early stage lung cancer patients was retrospectively assembled, which includes CT images, nine clinical and biological (CB) markers, and outcome of 3-yr disease-free survival (DFS) after surgery. Among the 94 patients, 74 remained DFS and 20 had cancer recurrence. Applying a computer-aided detection scheme, tumors were segmented from the CT images and 35 quantitative image (QI) features were initiallymore » computed. Two normalized Gaussian radial basis function network (RBFN) based classifiers were built based on QI features and CB markers separately. To improve prediction performance, the authors applied a synthetic minority oversampling technique (SMOTE) and a BestFirst based feature selection method to optimize the classifiers and also tested fusion methods to combine QI and CB based prediction results. Results: Using a leave-one-case-out cross-validation (K-fold cross-validation) method, the computed areas under a receiver operating characteristic curve (AUCs) were 0.716 ± 0.071 and 0.642 ± 0.061, when using the QI and CB based classifiers, respectively. By fusion of the scores generated by the two classifiers, AUC significantly increased to 0.859 ± 0.052 (p < 0.05) with an overall prediction accuracy of 89.4%. Conclusions: This study demonstrated the feasibility of improving prediction performance by integrating SMOTE, feature selection, and score fusion techniques. Combining QI features and CB markers and performing SMOTE prior to feature selection in classifier training enabled RBFN based classifier to yield improved prediction accuracy.« less

Phase Aberrations And Beam Cleanup Techniques In Carbon-Dioxide Laser Fusion Systems

NASA Astrophysics Data System (ADS)

Viswanathan, V. K.

1981-12-01

This paper describes the various carbon dioxide laser fusion systems at Los Alamos from the point of view of an optical designer. The types of phase aberrations present in these systems, as well as the beam cleanup techniques that can be used to improve the beam optical quality, are discussed. As this is a review article, some previously published results are also used where relevant.

Complications of anterior cervical discectomy and fusion using recombinant human bone morphogenetic protein-2

PubMed Central

Carp, Julia; Sethi, Anil; Bartol, Stephen; Craig, Joseph; Les, Clifford M.

2007-01-01

The use of bone morphogenetic protein-2 (rhBMP-2) in spinal fusion has increased dramatically since an FDA approval for its use in anterior lumbar fusion with the LT cage. There are several reports of its use in transforaminal lumbar interbody fusion, posterolateral fusion, and anterior cervical fusion. Reports on adverse effects of rhBMP-2 when used in spinal fusion are scarce in literature. An Institutional Review Board approved retrospective study was conducted in patients undergoing anterior spinal fusion and instrumentation following diskectomy at a single center. Forty-six consecutive patients were included. Twenty-two patients treated with rhBMP-2 and PEEK cages were compared to 24 in whom allograft spacers and demineralized bone matrix was used. Patients filled out Cervical Oswestry Scores, VAS for arm pain, neck pain, and had radiographs preoperatively as well at every follow up visit. Radiographic examination following surgery revealed end plate resorption in all patients in whom rhBMP-2 was used. This was followed by a period of new bone formation commencing at 6 weeks. In contrast, allograft patients showed a progressive blurring of end plate-allograft junction. Dysphagia was a common complication and it was significantly more frequent and more severe in patients in whom rhBMP-2 was used. Post operative swelling anterior to the vertebral body on lateral cervical spine X-ray was significantly larger in the rhBMP-2 group when measured from 1 to 6 weeks after which it was similar. These effects are possibly due to an early inflammatory response to rhBMP-2 and were observed to be dose related. With the parameters we used, there was no significant difference in the clinical outcome of patients in the two groups at 2 years. The cost of implants in patients treated with rhBMP-2 and PEEK spacers was more than three times the cost of allograft spacers and demineralized bone matrix in 1, 2, and 3-level cases. Despite providing consistently good fusion rates

Adverse Event Rates Associated with Transforaminal and Interlaminar Epidural Steroid Injections: A Multi-Institutional Study.

PubMed

El-Yahchouchi, Christine A; Plastaras, Christopher T; Maus, Timothy P; Carr, Carrie M; McCormick, Zachary L; Geske, Jennifer R; Smuck, Matthew; Pingree, Matthew J; Kennedy, David J

2016-02-01

Transforaminal epidural steroid injections (TFESI) have demonstrated efficacy and effectiveness in treatment of radicular pain. Despite little evidence of efficacy/effectiveness, interlaminar epidural steroid injections (ILESI) are advocated by some as primary therapy for radicular pain due to purported greater safety. To assess immediate and delayed adverse event rates of TFESI and ILESI injections at three academic medical centers utilizing International Spine Intervention Society practice guidelines. Quality assurance databases from a Radiology and two physical medicine and rehabilitation (PM&R) practices were interrogated. Medical records were reviewed, verifying immediate and delayed adverse events. There were no immediate major adverse events of neurologic injury or hemorrhage in 16,638 consecutive procedures in all spine segments (14,956 TFESI; 1,682 ILESI). Vasovagal reactions occurred in 1.2% of procedures, more frequently (P = 0.004) in TFESI (1.3%) than ILESI (0.5%). Dural punctures occurred in 0.06% of procedures, more commonly after ILESI (0.2% vs 0.04%, P = 0.006). Delayed follow up on PM&R patients (92.5% and 78.5, next business day) and radiology patients (63.1%, 2 weeks) identified no major adverse events of neurologic injury, hemorrhage, or infection. There were no significant differences in delayed minor adverse event rates. Central steroid response (sleeplessness, flushing, nonpositional headache) was seen in 2.6% of both TFESI and ILESI patients. 2.1% of TFESI and 1.8% of ILESI patients reported increased pain. No long-term sequelae were seen from any immediate or delayed minor adverse event. Both transforaminal and ILESI are safely performed with low immediate and delayed adverse event rates when informed by evidence-based procedural guidelines. By demonstrating comparable safety, this study suggests that the choice between ILESI and TFESIs can be based on documented efficacy and effectiveness and not driven by safety concerns.

Urban Classification Techniques Using the Fusion of LiDAR and Spectral Data

DTIC Science & Technology

2012-09-01

Photogrammetry and Remote Sensing, 62, 43–63. Stein, D., Beaven, S., Hoff, L., Winter, E., Schaum, A., & Stocker, A. (2002). Anomaly detection from...TECHNIQUES USING THE FUSION OF LIDAR AND SPECTRAL DATA by Justin E. Mesina September 2012 Thesis Advisor: Richard C . Olsen Second...from shadow anomalies . The fused results however, were not as accurate in differentiating trees from grasses as using only spectral results. Overall the

Recombinant human bone morphogenetic protein-2-augmented transforaminal lumbar interbody fusion for the treatment of chronic low back pain secondary to the homogeneous diagnosis of discogenic pain syndrome: two-year outcomes.

PubMed

Corenman, Donald S; Gillard, Douglas M; Dornan, Grant J; Strauch, Eric L

2013-09-15

A retrospective observational study. To assess clinical outcomes, perioperative complications, revision surgery rates, and recombinant human bone morphogenetic protein-2 (BMP-2)-related osteolysis, heterotopic bone, and unexplained postoperative radiculitis (BMPP) in a group of patients treated with BMP-2-augmented transforaminal lumbar interbody fusion (bTLIF) for the homogeneous diagnosis of discogenic pain syndrome (DPS) and to put forth the algorithm used to make the diagnosis. There is a paucity of literature describing outcomes of TLIF for the homogeneous diagnosis of DPS, an old but controversial member of the lumbar degenerative disease family. The registry from a single surgeon was queried for patients who had undergone bTLIF for the homogeneous diagnosis of DPS, which was made via specific diagnostic algorithm. Clinical outcomes were determined by analyzing point improvement from typical outcome questionnaires and the data from Patient Satisfaction and Return to Work questionnaires. Independent record review was used to assess all outcomes. Eighty percent of the cohort (36/45) completed preoperative and postoperative outcome questionnaires at an average follow-up of 41.9 ± 11.9 months, which demonstrated significant clinical improvement: Oswestry Disability Index = 16.4 (P < 0.0001), 12-Item Short Form Health Survey physical component summary score = 10.0 (P < 0.0001), and a Numeric Rating Scale for back pain = 2.3 (P < 0.0001). The median patient satisfaction score was 9.0 (10 = complete satisfaction), and 84.4% (27/32) of the cohort were able to return to their preoperative job, with or without modification. There were 3 perioperative complications, 4 revision surgical procedures, and 11 cases of benign BMPP. There were no incidents of the intraoperative dural tears or nerve root injury, and litigation involvement (11/36, P > 0.17), preoperative depression (15/36, P > 0.19) or prior discectomy/decompression (14/36, P < 0.37) was not a predictor of

Retrospective exploration of risk factors for L5 radiculopathy following lumbar floating fusion surgery.

PubMed

Orita, Sumihisa; Yamagata, Masatsune; Ikeda, Yoshikazu; Nakajima, Fumitake; Aoki, Yasuchika; Nakamura, Junichi; Takahashi, Kazuhisa; Suzuki, Takane; Ohtori, Seiji

2015-10-17

Lumbar floating fusion occasionally causes postoperative adjacent segment disorder (ASD) at lumbosacral level, causing L5 spinal nerve disorder by L5-S1 foraminal stenosis. The disorder is considered to be one of the major outcomes of L5-S1 ASD, which has not been evaluated yet. The present study aimed to evaluate the incidence and risk factors of postoperative L5 spinal nerve disorder after lumbar interbody fusion extending to the L5 vertebra. We evaluated 125 patients with a diagnosis of spondylolisthesis who underwent floating fusion surgery with transforaminal lumbar interbody fusion with average postoperative period of 25.2 months. The patients were regarded as symptomatic with postoperative L5 spinal nerve disorder such as radicular pain/numbness in the lower limbs and/or motor dysfunction. We estimated and compared the wedging angle (frontal view) and height (lateral view) of the lumbosacral junction in pre- and postoperative plain X-ray images and the foraminal ratio (ratio of the narrower foraminal diameter to the wider diameter in the craniocaudal direction) in the preoperative magnetic resonance image. Risk factors for the incidence of L5 spinal nerve disorder were explored using multivariate logistic regression. Eight of the 125 patients (6.4%) were categorized as symptomatic, an average of 13.3 months after surgery. The wedging angle was significantly higher, and the foraminal ratio was significantly decreased in the symptomatic group (both P < 0.05) compared to the asymptomatic group. Multivariate logistic regression analysis of possible risk factors revealed that the wedging angle, foraminal ratio, and multileveled fusion were statistically significant. Higher wedging angle and lower foraminal ratio in the lumbosacral junction were significantly predictive for the incidence of L5 nerve root disorder as well as multiple-leveled fusion. These findings indicate that lumbosacral fixation should be considered for patients with these risk factors even

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.

[Biomechanics changes of lumbar spine caused by foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy].

PubMed

Qian, J; Yu, S S; Liu, J J; Chen, L; Jing, J H

2018-04-03

Objective: To analyze the biomechanics changes of lumbar spine caused by foraminotomy via percutaneous transforaminal endoscopic lumbar discectomy using the finite element method. Methods: Three healthy adult males (aged 35.6 to 42.3 years) without spinal diseases were enrolled in this study and 3D-CT scans were carried out to obtain the parameters of lumbar spine. Mimics software was applied to build a 3D finite element model of lumbar spine. Graded resections (1/4, 2/4, 3/4 and 4/4) of the left superior articular process of L(5) were done via percutaneous transforaminal endoscopic lumbar discectomy. Then, the pressure of the L(4/5) right facets, the pressure of the L(4/5) intervertebral disc and the motion of lumbar spine were recorded after simulating the normal flexion and extension, lateral flexion and rotation of the lumbar spine model during different resections. The data were compared among groups with analysis of variance. Results: Comparing with the normal group, after 1/4 resection of the left superior articular process of L(5), the pressure of the L(4/5) right facets showed significant differences during left lateral flexion and rotation of lumbar spine ( q =8.823, 8.248, both P <0.05); and the pressure of L(4/5) intervertebral disc also changed significantly during extension and right rotation of lumbar spine ( q =6.918, 6.438, both P <0.05); the motion of lumbar spine showed obvious differences during right lateral flexion and rotation ( q =6.845, 7.772, 13.58, all P <0.05). Comparing with the normal group, after 2/4 resection of the left superior articular process of L(5), the pressure of the L(4/5) right facets presented significant differences during all conditions ( q =5.670-17.830, all P <0.05); the pressure of L(4/5) intervertebral disc changed significantly during flexion, extension, lateral flexion and right rotation ( q =5.260, 17.150, 5.727, 8.890, 15.660, all P <0.05); the motion of lumbar spine also existed differences during extension

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. Copyright © 2016 Elsevier Ltd. All rights reserved.

Revisions for screw malposition and clinical outcomes after robot-guided lumbar fusion for spondylolisthesis.

PubMed

Schröder, Marc L; Staartjes, Victor E

2017-05-01

OBJECTIVE The accuracy of robot-guided pedicle screw placement has been proven to be high, but little is known about the impact of such guidance on clinical outcomes such as the rate of revision surgeries for screw malposition. In addition, there are very few data about the impact of robot-guided fusion on patient-reported outcomes (PROs). Thus, the clinical benefit for the patient is unclear. In this study, the authors analyzed revision rates for screw malposition and changes in PROs following minimally invasive robot-guided pedicle screw fixation. METHODS A retrospective cohort study of patients who had undergone minimally invasive posterior lumbar interbody fusion (MI-PLIF) or minimally invasive transforaminal lumbar interbody fusion was performed. Patients were followed up clinically at 6 weeks, 12 months, and 24 months after treatment and by mailed questionnaire in March 2016 as a final follow-up. Visual analog scale (VAS) scores for back and leg pain severity, Oswestry Disability Index (ODI), screw revisions, and socio-demographic factors were analyzed. A literature review was performed, comparing the incidence of intraoperative screw revisions and revision surgery for screw malposition in robot-guided, navigated, and freehand fusion procedures. RESULTS Seventy-two patients fit the study inclusion criteria and had a mean follow up of 32 ± 17 months. No screws had to be revised intraoperatively, and no revision surgery for screw malposition was needed. In the literature review, the authors found a higher rate of intraoperative screw revisions in the navigated pool than in the robot-guided pool (p < 0.001, OR 9.7). Additionally, a higher incidence of revision surgery for screw malposition was observed for freehand procedures than for the robot-guided procedures (p < 0.001, OR 8.1). The VAS score for back pain improved significantly from 66.9 ± 25.0 preoperatively to 30.1 ± 26.8 at the final follow-up, as did the VAS score for leg pain (from 70.6 ± 22.8 to

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.

Technologies for Army Knowledge Fusion

DTIC Science & Technology

2004-09-01

interpret it in context and understand the implications (Alberts et al., 2002). Note that the knowledge / information fusion issue arises immediately here...Army Knowledge Fusion Richard Scherl Department of Computer Science Monmouth University Dana L. Ulery Computational and Information Sciences...civilian and military sources. Knowledge fusion, also called information fusion and multisensor data fusion, names the body of techniques needed to

Diagnosis and operatory treatment of the patients with failed back surgery caused by herniated disk relapse.

PubMed

Bodiu, A

2014-01-01

THE OBJECT OF STUDY: Analysis of surgical treatment results in patients with recurrent lumbar disc herniation by transforaminal lumbar interbody fusion (TLIF) and repeated laminotomy and discectomy for the improvement of pain and disability. Data analysis was performed on a complex diagnosis and treatment of 56 patients with recurrent lumbar disc herniation who had previously underwent 1-3 lumbar disc surgeries. An MRI investigation with paramagnetic contrast agent (gadolinium) was used for the diagnosis and differentiation of epidural fibrosis, and a dynamic lateral X-ray investigation was carried out for the identification of segmental instability. The evolution period after the previous surgery was between 1 and 3 years after the index surgery. Pain expression degree and dynamics were assessed with the pain visual analog scale (VAS) in early and late postoperative periods. Postoperative success was assessed by using a modified MacNab scale. The follow-up recording period after the last operation was of at least 1 year, ranging from 1 to 4 years. The surgical treatment was effective in most cases, recording a reduction in pain expression level from 7.2-7.7 points on the VAS scale to 1.7-2.1 in the early period and 2.2-2.6 in the late period (1 year). Repeated surgery was effective in 21 of 30 (70%) cases who underwent decompression surgery without fusion and in 20 of 26 (76.9%) cases who underwent repeated surgery with transforaminal lumbar interbody fusion (TLIF). Overall, postoperative success was assessed by using a modified MacNab scale. Repeated surgery is a viable option for patients who have clinical manifestations of recurrent disc herniation. Investigation with contrast agent by MRI allows differentiating disk herniation recurrences from epidural fibrosis. Supplementing repeated discectomies and decompression with intervertebral transforaminal fusion provide superior clinical outcomes, especially in patients with clinical and radiological signs of lumbar

A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT).

PubMed

de Kunder, Suzanne L; Rijkers, Kim; van Kuijk, Sander M J; Evers, Silvia M A A; de Bie, Rob A; van Santbrink, Henk

2016-10-06

With a steep increase in the number of instrumented spinal fusion procedures, there is a need for comparative data to develop evidence based treatment recommendations. Currently, the available data on cost and clinical effectiveness of the two most frequently performed surgeries for lumbar spondylolisthesis, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF), are not sufficient. Therefore, current guidelines do not advise which is the most appropriate surgical treatment strategy for these patients. Non-randomized studies comparing TLIF and PLIF moreover suggest that TLIF is associated with fewer complications, less blood loss, shorter surgical time and hospital duration. TLIF may therefore be more cost-effective. The results of this study will provide knowledge on short- and long-term clinical and economical effects of TLIF and PLIF procedures, which will lead to recommendations for treating patients with lumbar spondylolisthesis. Multicenter blinded Randomized Controlled Trial (RCT; blinding for the patient and statistician, not for the clinician and researcher). A total of 144 patients over 18 years old with symptomatic single level lumbar degenerative, isthmic or iatrogenic spondylolisthesis whom are candidates for LIF (lumbar interbody fusion) surgery through a posterior approach will be randomly allocated to TLIF or PLIF. The study will consist of three parts: 1) a clinical effectiveness study, 2) a cost-effectiveness study, and 3) a process evaluation. The primary clinical outcome measures are: change in disability measured with Oswestry Disability Index (ODI) and change in quality adjusted life years (QALY) measured with EQ-5D-5L. Secondary clinical outcome measures are: Short Form (36) Health Survey (SF-36), VAS back pain, VAS leg pain, Hospital Anxiety Depression Scale (HADS), complications, productivity related costs (iPCQ) and medical costs (iMCQ). Measurements will be carried out at five fixed time points (pre

[Effects of robot-assisted minimally invasive transforaminal lumbar interbody fusion and traditional open surgery in the treatment of lumbar spondylolisthesis].

PubMed

Cui, G Y; Tian, W; He, D; Xing, Y G; Liu, B; Yuan, Q; Wang, Y Q; Sun, Y Q

2017-07-01

Objective: To compare the clinical effects of robot-assisted minimally invasive transforaminal lumbar interbody fusion (TLIF) and traditional open TLIF in the treatment of lumbar spondylolisthesis. Methods: A total of 41 patients with lumbar spondylolisthesis accepted surgical treatment in Department of Spinal Surgery of Beijing Jishuitan Hospital From July 2015 to April 2016 were retrospectively analyzed. There were 16 cases accepted robot-assisted minimally invasive TLIF and 25 accepted traditional open TLIF. The operation time, X-ray radiation exposure time, perioperative bleeding, drainage volume, time of hospitalization, time for pain relief, time for ambulatory recovery, visual analogue scale (VAS), Oswestry disability index (ODI) and complications were compared. T test and χ(2) were used to analyze data. Results: There were no significant difference in gender, age, numbers, degrees, pre-operative VAS and ODI in spondylolisthesis (all P >0.05). Compared with traditional open TLIF group, the robot-assisted minimally invasive TLIF group had less perioperative bleeding ((187.5±18.4) ml vs . (332.1±23.5) ml), less drainage volume ((103.1±15.6) ml vs . (261.3±19.8) ml), shorter hospitalization ((7.8±1.9) days vs . (10.0±1.6) days), shorter time for pain relief ((2.8±1.0) days vs . (5.2±1.1) days), shorter time for ambulatory recovery ((1.7±0.9) days vs . (2.9±1.3) days) and less VAS of the third day postoperatively (2.2±0.9 vs . 4.2±2.4) ( t =2.762-16.738, all P <0.05), but need more operation time ((151.3±12.3) minutes vs . (102.2±7.1) minutes) and more X-ray radiation exposure ((26.1±3.3) seconds vs . (5.5±2.1) seconds) ( t =6.125, 15.168, both P <0.01). In both groups ODI was significantly lower in final follow-up than that of the pre-operation ( t =12.215, 14.036, P <0.01). Intervertebral disc height of the final follow-up in both groups were significantly larger than that of the preoperation (robot-assisted minimally invasive TLIF group: (11

A randomised controlled trial of transforaminal endoscopic discectomy vs microdiscectomy.

PubMed

Gibson, J N Alaistair; Subramanian, Ashok S; Scott, Chloe E H

2017-03-01

Transforaminal endoscopic discectomy (TED) minimises paraspinal muscle damage. The aim of this trial was to compare clinical outcomes of TED to Microdiscectomy (Micro). 143 patients, age 25-70 years and <115 kg, with single level lumbar prolapse and radiculopathy, were recruited and randomised. 70 received TED under conscious sedation and 70 Micro under general anaesthesia. Oswestry Disability Index (ODI), visual analogue scores (VAS) of back and leg pain, and Short Form Health Survey indices (SF-36) were measured preoperatively and at 3, 12 and 24 months. All outcome measures improved significantly in both groups (p < 0.001). Affected side leg pain was lower in the TED group at 2 years (1.9 ± 2.6 vs 3.5 ± 3.1, p = 0.002). Hospital stay was shorter following TED (0.7 ± 0.7 vs 1.4 ± 1.3 days, p < 0.001). Two Micro patients and five TED patients required revision giving a relative risk of revision for TED of 2.62 (95% CI 0.49-14.0). Functional improvements were maintained at 2 years in both groups with less ongoing sciatica after TED. A greater revision rate after TED was offset by a more rapid recovery.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abi-Jaoudeh, Nadine, E-mail: naj@mail.nih.gov; Kruecker, Jochen, E-mail: jochen.kruecker@philips.com; Kadoury, Samuel, E-mail: samuel.kadoury@polymtl.ca

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 methodsmore » 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.« less

Salvage of infected total knee fusion: the last option.

PubMed

Wiedel, Jerome D

2002-11-01

Currently the most common indication for an arthrodesis of the knee is a failed infected total knee prosthesis. Other causes of a failed total knee replacement that might necessitate a knee fusion include aseptic loosening, deficient extensor mechanism, poor soft tissues, and Charcot joint. Techniques available for achieving a knee fusion are external fixation and internal fixation methods. The external fixation compression devices have been the most widely used for knee fusion and have been successful until the indications for fusion changed to mostly failed prosthetic knee replacement. With failed total knee replacement, the problem of severe bone loss became an issue, and the external fixation compression devices, even including the biplane external fixators, have been the least successful method reported for gaining fusion. The Ilizarov technique has been shown to achieve rigid fixation despite this bone loss, and a review of reports are showing high fusion rates using this method. Internal fixation methods including plate fixation and intramedullary nails have had the best success in gaining fusion in the face of this bone loss and have replaced external fixation methods as the technique of choice for knee fusion when severe bone loss is present. A review of the literature and a discussion of different fusion techniques are presented including a discussion of the influence that infection has on the success of fusion.

Transforaminal Anterior Release for the Treatment of Fixed Sagittal Imbalance and Segmental Kyphosis, Minimum 2-Year Follow-Up Study.

PubMed

Sweet, Fred A; Sweet, Andrea

2015-09-01

Retrospective review of prospectively accrued patient cohort. To report minimum 2 years' follow-up after a single-surgeon series of 47 consecutive patients in whom fixed sagittal imbalance or segmental kyphosis was treated with a novel unilateral transforaminal annular release. Fixed sagittal imbalance has been treated most recently with pedicle subtraction osteotomy with great success but is associated with significant blood loss and neurologic risk. Forty-seven consecutive patients with fixed sagittal imbalance (n = 29) or segmental kyphosis (n = 18) were treated by a single surgeon with a single-level transforaminal anterior release (TFAR) to effect an opening wedge correction. Sagittal and coronal correction was performed with in situ rod contouring. An interbody cage was captured in the disc space with rod compression. Radiographic and clinical outcome analysis was performed with a minimum 2-year follow-up (range 2-7.8 years). The average increase in lordosis was 36° (range 24°-56°) in the fixed sagittal deformity group. Coronal corrections averaged 34° (range 18°-48°). The average improvement in plumb line was 13.6 cm. There were four pseudarthroses, one at the TFAR. Average blood loss was 578 mL (range 200-1,200). One patient had a transient grade 4/5 anterior tibialis weakness. There were no vascular injuries or permanent neurologic deficits. There were significant improvements in the Oswestry Disability Index (p < .001) and Scoliosis Research Society Questionnaire scores (p = .003). Eighty-four percent of patients reported improvement in pain, self-image, and satisfaction with the procedure. TFAR is a useful procedure for correcting segmental kyphosis and fixed sagittal imbalance with relatively low blood loss and was found to be neurologically safe in this single-surgeon series. Therapeutic study, Level IV (case series, no control group). Copyright © 2015 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

MR angiography fusion technique for treatment planning of intracranial arteriovenous malformations.

PubMed

McGee, Kiaran P; Ivanovic, Vladimir; Felmlee, Joel P; Meyer, Fredrick B; Pollock, Bruce E; Huston, John

2006-03-01

To develop an image fusion technique using elliptical centric contrast-enhanced (CE) MR angiography (MRA) and three-dimensional (3D) time-of-flight (TOF) acquisitions for radiosurgery treatment planning of arteriovenous malformations (AVMs). CE and 3D-TOF MR angiograms with disparate in-plane fields of view (FOVs) were acquired, followed by k-space reformatting to provide equal voxel dimensions. Spatial domain addition was performed to provide a third, fused data volume. Spatial distortion was evaluated on an MRA phantom and provided slice-dependent and global distortion along the three physical dimensions of the MR scanner. In vivo validation was performed on 10 patients with intracranial AVMs prior to their conventional angiogram on the day of gamma knife radiosurgery. Spatial distortion in the phantom within a volume of 14 x 14 x 3.2 cm(3) was less than +/-1 mm (+/-1 standard deviation (SD)) for CE and 3D-TOF data sets. Fused data volumes were successfully generated for all 10 patients. Image fusion can be used to obtain high-resolution CE-MRA images of intracranial AVMs while keeping the fiducial markers needed for gamma knife radiosurgery planning. The spatial fidelity of these data is within the tolerance acceptable for daily quality control (QC) purposes and gamma knife treatment planning. (c) 2006 Wiley-Liss, Inc.

Quantitative image fusion in infrared radiometry

NASA Astrophysics Data System (ADS)

Romm, Iliya; Cukurel, Beni

2018-05-01

Towards high-accuracy infrared radiance estimates, measurement practices and processing techniques aimed to achieve quantitative image fusion using a set of multi-exposure images of a static scene are reviewed. The conventional non-uniformity correction technique is extended, as the original is incompatible with quantitative fusion. Recognizing the inherent limitations of even the extended non-uniformity correction, an alternative measurement methodology, which relies on estimates of the detector bias using self-calibration, is developed. Combining data from multi-exposure images, two novel image fusion techniques that ultimately provide high tonal fidelity of a photoquantity are considered: ‘subtract-then-fuse’, which conducts image subtraction in the camera output domain and partially negates the bias frame contribution common to both the dark and scene frames; and ‘fuse-then-subtract’, which reconstructs the bias frame explicitly and conducts image fusion independently for the dark and the scene frames, followed by subtraction in the photoquantity domain. The performances of the different techniques are evaluated for various synthetic and experimental data, identifying the factors contributing to potential degradation of the image quality. The findings reflect the superiority of the ‘fuse-then-subtract’ approach, conducting image fusion via per-pixel nonlinear weighted least squares optimization.

The effectiveness of repeat lumbar transforaminal epidural steroid injections.

PubMed

Murthy, Naveen S; Geske, Jennifer R; Shelerud, Randy A; Wald, John T; Diehn, Felix E; Thielen, Kent R; Kaufmann, Timothy J; Morris, Jonathan M; Lehman, Vance T; Amrami, Kimberly K; Carter, Rickey E; Maus, Timothy P

2014-10-01

The aim of this study was to determine 1) if repeat lumbar transforaminal epidural steroid injections (TFESIs) resulted in recovery of pain relief, which has waned since an index injection, and 2) if cumulative benefit could be achieved by repeat injections within 3 months of the index injection. Retrospective observational study with statistical modeling of the response to repeat TFESI. Academic radiology practice. Two thousand eighty-seven single-level TFESIs were performed for radicular pain on 933 subjects. Subjects received repeat TFESIs >2 weeks and <1 year from the index injection. Hierarchical linear modeling was performed to evaluate changes in continuous and categorical pain relief outcomes after repeat TFESI. Subgroup analyses were performed on patients with <3 months duration of pain (acute pain), patients receiving repeat injections within 3 months (clustered injections), and in patients with both acute pain and clustered injections. Repeat TFESIs achieved pain relief in both continuous and categorical outcomes. Relative to the index injection, there was a minimal but statistically significant decrease in pain relief in modeled continuous outcome measures with subsequent injections. Acute pain patients recovered all prior benefit with a statistically significant cumulative benefit. Patients receiving clustered injections achieved statistically significant cumulative benefit, of greater magnitude in acute pain patients. Repeat TFESI may be performed for recurrence of radicular pain with the expectation of recovery of most or all previously achieved benefit; acute pain patients will likely recover all prior benefit. Repeat TFESIs within 3 months of the index injection can provide cumulative benefit. Wiley Periodicals, Inc.

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; JET Contributors

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.

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

Integrated Data Analysis for Fusion: A Bayesian Tutorial for Fusion Diagnosticians

NASA Astrophysics Data System (ADS)

Dinklage, Andreas; Dreier, Heiko; Fischer, Rainer; Gori, Silvio; Preuss, Roland; Toussaint, Udo von

2008-03-01

Integrated Data Analysis (IDA) offers a unified way of combining information relevant to fusion experiments. Thereby, IDA meets with typical issues arising in fusion data analysis. In IDA, all information is consistently formulated as probability density functions quantifying uncertainties in the analysis within the Bayesian probability theory. For a single diagnostic, IDA allows the identification of faulty measurements and improvements in the setup. For a set of diagnostics, IDA gives joint error distributions allowing the comparison and integration of different diagnostics results. Validation of physics models can be performed by model comparison techniques. Typical data analysis applications benefit from IDA capabilities of nonlinear error propagation, the inclusion of systematic effects and the comparison of different physics models. Applications range from outlier detection, background discrimination, model assessment and design of diagnostics. In order to cope with next step fusion device requirements, appropriate techniques are explored for fast analysis applications.

Cost-utility analysis of posterior minimally invasive fusion compared with conventional open fusion for lumbar spondylolisthesis

PubMed Central

Rampersaud, Y. Raja; Gray, Randolph; Lewis, Steven J.; Massicotte, Eric M.; Fehlings, Michael G.

2011-01-01

Background The utility and cost of minimally invasive surgical (MIS) fusion remain controversial. The primary objective of this study was to compare the direct economic impact of 1- and 2-level fusion for grade I or II degenerative or isthmic spondylolisthesis via an MIS technique compared with conventional open posterior decompression and fusion. Methods A retrospective cohort study was performed by use of prospective data from 78 consecutive patients (37 with MIS technique by 1 surgeon and 41 with open technique by 3 surgeons). Independent review of demographic, intraoperative, and acute postoperative data was performed. Oswestry disability index (ODI) and Short Form 36 (SF-36) values were prospectively collected preoperatively and at 1 year postoperatively. Cost-utility analysis was performed by use of in-hospital micro-costing data (operating room, nursing, imaging, laboratories, pharmacy, and allied health cost) and change in health utility index (SF-6D) at 1 year. Results The groups were comparable in terms of age, sex, preoperative hemoglobin, comorbidities, and body mass index. Groups significantly differed (P < .01) regarding baseline ODI and SF-6D scores, as well as number of 2-level fusions (MIS, 12; open, 20) and number of interbody cages (MIS, 45; open, 14). Blood loss (200 mL vs 798 mL), transfusions (0% vs 17%), and length of stay (LOS) (6.1 days vs 8.4 days) were significantly (P < .01) lower in the MIS group. Complications were also fewer in the MIS group (4 vs 12, P < .02). The mean cost of an open fusion was 1.28 times greater than that of an MIS fusion (P = .001). Both groups had significant improvement in 1-year outcome. The changes in ODI and SF-6D scores were not statistically different between groups. Multivariate regression analysis showed that LOS and number of levels fused were independent predictors of cost. Age and MIS were the only predictors of LOS. Baseline outcomes and MIS were predictors of 1-year outcome. Conclusion MIS posterior

Hybrid Decompression Technique Versus Anterior Cervical Corpectomy and Fusion for Treating Multilevel Cervical Spondylotic Myelopathy: Which One Is Better?

PubMed

Liu, Jia-Ming; Peng, Hong-Wei; Liu, Zhi-Li; Long, Xin-Hua; Yu, Yan-Qing; Huang, Shan-Hu

2015-12-01

The hybrid decompression technique (corpectomy combined with discectomy) and anterior cervical corpectomy with fusion (ACCF) both provide good neurological recovery and disease stabilization for the treatment of multilevel cervical spondylotic myelopathy (CSM). However, no single study has been large enough to determine definitively which one is superior for this condition. A meta-analysis was conducted to compare the clinical efficacy and safety of the hybrid decompression technique versus ACCF for the treatment of multilevel CSM. Electronic databases such as PubMed, MEDLINE, EMBASE, Google Scholar, and the Cochrane Library were selected to search for potentially relevant trials up to April 2015 that compared the outcomes of the hybrid technique with ACCF for the treatment of multilevel CSM. Data extraction and quality assessment were performed according to Cochrane Collaboration guidelines. The outcome assessments were duration of surgery, blood loss, Cobb angle of C2-C7, segment angle, fusion rate, Japanese Orthopedics Association score, Neck Disability Index, and complications. The results were expressed as the odds ratio (OR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes with a 95% confidence interval (CI). Five controlled clinical trials published between 2009 and 2013, involving 356 patients (hybrid, 196; ACCF, 160) with 3- or 4-level CSM were retrieved in this study. Overall, there were significant differences between the 2 treatment groups for blood loss (MD = -38.69, 95% CI = -54.62 to -22.76, P < 0.01), fusion rate (OR = 2.56, 95% CI = 1.11 to 5.93, P = 0.03), and complications (OR = 0.25, 95% CI = 0.15 to 0.43, P < 0.01). However, no significant differences were found for duration of surgery (MD = -4.50, 95% CI = -22.902 to 13.91, P = 0.63), Cobb angle of C2-C7 after surgery (MD = 3.32, 95% CI = -3.72 to 10.37, P = 0.35), segment angle after surgery (MD = 2.87, 95% CI = -2.47 to 8.21, P = 0.29), Japanese Orthopedics

Properties of an interspinous fixation device (ISD) in lumbar fusion constructs: a biomechanical study.

PubMed

Techy, Fernando; Mageswaran, Prasath; Colbrunn, Robb W; Bonner, Tara F; McLain, Robert F

2013-05-01

Segmental fixation improves fusion rates and promotes patient mobility by controlling instability after lumbar surgery. Efforts to obtain stability using less invasive techniques have lead to the advent of new implants and constructs. A new interspinous fixation device (ISD) has been introduced as a minimally invasive method of stabilizing two adjacent interspinous processes by augmenting an interbody cage in transforaminal interbody fusion. The ISD is intended to replace the standard pedicle screw instrumentation used for posterior fixation. The purpose of this study is to compare the rigidity of these implant systems when supplementing an interbody cage as used in transforaminal lumbar interbody fusion. An in vitro human cadaveric biomechanical study. Seven human cadaver spines (T12 to the sacrum) were mounted in a custom-designed testing apparatus, for biomechanical testing using a multiaxial robotic system. A comparison of segmental stiffness was carried out among five conditions: intact spine control; interbody spacer (IBS), alone; interbody cage with ISD; IBS, ISD, and unilateral pedicle screws (unilat); and IBS, with bilateral pedicle screws (bilat). An industrial robot (KUKA, GmbH, Augsburg, Germany) applied a pure moment (±5 Nm) in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) through an anchor to the T12 vertebral body. The relative vertebral motion was captured using an optoelectronic camera system (Optotrak; Northern Digital, Inc., Waterloo, Ontario, Canada). The load sensor and the camera were synchronized. Maximum rotation was measured at each level and compared with the intact control. Implant constructs were compared with the control and with each other. A statistical analysis was performed using analysis of variance. A comparison between the intact spine and the IBS group showed no significant difference in the range of motion (ROM) in FE, LB, or AR for the operated level, L3-L4. After implantation of the ISD to augment

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

[Possibilities of sonographic image fusion: Current developments].

PubMed

Jung, E M; Clevert, D-A

2015-11-01

For diagnostic and interventional procedures ultrasound (US) image fusion can be used as a complementary imaging technique. Image fusion has the advantage of real time imaging and can be combined with other cross-sectional imaging techniques. With the introduction of US contrast agents sonography and image fusion have gained more importance in the detection and characterization of liver lesions. Fusion of US images with computed tomography (CT) or magnetic resonance imaging (MRI) facilitates the diagnostics and postinterventional therapy control. In addition to the primary application of image fusion in the diagnosis and treatment of liver lesions, there are more useful indications for contrast-enhanced US (CEUS) in routine clinical diagnostic procedures, such as intraoperative US (IOUS), vascular imaging and diagnostics of other organs, such as the kidneys and prostate gland.

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.

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.

Use of minimally invasive spine surgical instruments for the treatment of bone tumors.

PubMed

Reeves, Russell A; DeWolf, Matthew C; Shaughnessy, Peter J; Ames, James B; Henderson, Eric R

2017-11-01

Orthopedic oncologists often encounter patients with minor bony lesions that are difficult to access surgically and therefore require large exposures out of proportion to the severity of disease that confer significant patient morbidity. Minimally invasive surgical techniques offer the advantage of smaller incisions, shorter operative times, decreased tissue damage, and decreased costs. A variety of surgical procedures have emerged using minimally invasive technologies, particularly in the field of spine surgery. Areas covered: In this article, we describe the Minimal Exposure Tubular Retractor (METRx TM ) System which is a minimally invasive surgical device that utilizes a series of dilators to permit access to a surgical site of interest. This system was developed for use in treatment of disc herniation, spinal stenosis, posterior lumbar interbody fusion, transforaminal lumbar interbody fusion and spinal cord stimulation implantation. We also describe novel uses of this system for minimally invasive biopsy and treatment of benign and metastatic bone lesions at our institution. Expert commentary: Minimally invasive surgical techniques will continue to expand into the field of orthopedic oncology. With a greater number of studies proving the safety and effectiveness of this technique, the demand for minimally invasive treatments will grow.

Information Fusion - Methods and Aggregation Operators

NASA Astrophysics Data System (ADS)

Torra, Vicenç

Information fusion techniques are commonly applied in Data Mining and Knowledge Discovery. In this chapter, we will give an overview of such applications considering their three main uses. This is, we consider fusion methods for data preprocessing, model building and information extraction. Some aggregation operators (i.e. particular fusion methods) and their properties are briefly described as well.

Investigations of image fusion

NASA Astrophysics Data System (ADS)

Zhang, Zhong

1999-12-01

The objective of image fusion is to combine information from multiple images of the same scene. The result of image fusion is a single image which is more suitable for the purpose of human visual perception or further image processing tasks. In this thesis, a region-based fusion algorithm using the wavelet transform is proposed. The identification of important features in each image, such as edges and regions of interest, are used to guide the fusion process. The idea of multiscale grouping is also introduced and a generic image fusion framework based on multiscale decomposition is studied. The framework includes all of the existing multiscale-decomposition- based fusion approaches we found in the literature which did not assume a statistical model for the source images. Comparisons indicate that our framework includes some new approaches which outperform the existing approaches for the cases we consider. Registration must precede our fusion algorithms. So we proposed a hybrid scheme which uses both feature-based and intensity-based methods. The idea of robust estimation of optical flow from time- varying images is employed with a coarse-to-fine multi- resolution approach and feature-based registration to overcome some of the limitations of the intensity-based schemes. Experiments show that this approach is robust and efficient. Assessing image fusion performance in a real application is a complicated issue. In this dissertation, a mixture probability density function model is used in conjunction with the Expectation- Maximization algorithm to model histograms of edge intensity. Some new techniques are proposed for estimating the quality of a noisy image of a natural scene. Such quality measures can be used to guide the fusion. Finally, we study fusion of images obtained from several copies of a new type of camera developed for video surveillance. Our techniques increase the capability and reliability of the surveillance system and provide an easy way to obtain 3-D

An accurate automated technique for quasi-optics measurement of the microwave diagnostics for fusion plasma

NASA Astrophysics Data System (ADS)

Hu, Jianqiang; Liu, Ahdi; Zhou, Chu; Zhang, Xiaohui; Wang, Mingyuan; Zhang, Jin; Feng, Xi; Li, Hong; Xie, Jinlin; Liu, Wandong; Yu, Changxuan

2017-08-01

A new integrated technique for fast and accurate measurement of the quasi-optics, especially for the microwave/millimeter wave diagnostic systems of fusion plasma, has been developed. Using the LabVIEW-based comprehensive scanning system, we can realize not only automatic but also fast and accurate measurement, which will help to eliminate the effects of temperature drift and standing wave/multi-reflection. With the Matlab-based asymmetric two-dimensional Gaussian fitting method, all the desired parameters of the microwave beam can be obtained. This technique can be used in the design and testing of microwave diagnostic systems such as reflectometers and the electron cyclotron emission imaging diagnostic systems of the Experimental Advanced Superconducting Tokamak.

Advanced particle-in-cell simulation techniques for modeling the Lockheed Martin Compact Fusion Reactor

NASA Astrophysics Data System (ADS)

Welch, Dale; Font, Gabriel; Mitchell, Robert; Rose, David

2017-10-01

We report on particle-in-cell developments of the study of the Compact Fusion Reactor. Millisecond, two and three-dimensional simulations (cubic meter volume) of confinement and neutral beam heating of the magnetic confinement device requires accurate representation of the complex orbits, near perfect energy conservation, and significant computational power. In order to determine initial plasma fill and neutral beam heating, these simulations include ionization, elastic and charge exchange hydrogen reactions. To this end, we are pursuing fast electromagnetic kinetic modeling algorithms including a two implicit techniques and a hybrid quasi-neutral algorithm with kinetic ions. The kinetic modeling includes use of the Poisson-corrected direct implicit, magnetic implicit, as well as second-order cloud-in-cell techniques. The hybrid algorithm, ignoring electron inertial effects, is two orders of magnitude faster than kinetic but not as accurate with respect to confinement. The advantages and disadvantages of these techniques will be presented. Funded by Lockheed Martin.

On the path to fusion energy

NASA Astrophysics Data System (ADS)

Tabak, M.

2016-10-01

There is a need to develop alternate energy sources in the coming century because fossil fuels will become depleted and their use may lead to global climate change. Inertial fusion can become such an energy source, but significant progress must be made before its promise is realized. The high-density approach to inertial fusion suggested by Nuckolls et al. leads reaction chambers compatible with civilian power production. Methods to achieve the good control of hydrodynamic stability and implosion symmetry required to achieve these high fuel densities will be discussed. Fast Ignition, a technique that achieves fusion ignition by igniting fusion fuel after it is assembled, will be described along with its gain curves. Fusion costs of energy for conventional hotspot ignition will be compared with those of Fast Ignition and their capital costs compared with advanced fission plants. Finally, techniques that may improve possible Fast Ignition gains by an order of magnitude and reduce driver scales by an order of magnitude below conventional ignition requirements are described.

A near-optimal low complexity sensor fusion technique for accurate indoor localization based on ultrasound time of arrival measurements from low-quality sensors

NASA Astrophysics Data System (ADS)

Mitilineos, Stelios A.; Argyreas, Nick D.; Thomopoulos, Stelios C. A.

2009-05-01

A fusion-based localization technique for location-based services in indoor environments is introduced herein, based on ultrasound time-of-arrival measurements from multiple off-the-shelf range estimating sensors which are used in a market-available localization system. In-situ field measurements results indicated that the respective off-the-shelf system was unable to estimate position in most of the cases, while the underlying sensors are of low-quality and yield highly inaccurate range and position estimates. An extensive analysis is performed and a model of the sensor-performance characteristics is established. A low-complexity but accurate sensor fusion and localization technique is then developed, which consists inof evaluating multiple sensor measurements and selecting the one that is considered most-accurate based on the underlying sensor model. Optimality, in the sense of a genie selecting the optimum sensor, is subsequently evaluated and compared to the proposed technique. The experimental results indicate that the proposed fusion method exhibits near-optimal performance and, albeit being theoretically suboptimal, it largely overcomes most flaws of the underlying single-sensor system resulting in a localization system of increased accuracy, robustness and availability.

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.

Simultaneous measurement of the HT and DT fusion burn histories in inertial fusion implosions

DOE PAGES

Zylstra, Alex B.; Herrmann, Hans W.; Kim, Yong Ho; ...

2017-05-23

Measuring the thermonuclear burn history is an important way to diagnose inertial fusion implosions. Here, using the gas Cherenkov detectors at the OMEGA laser facility, we measure the HT fusion burn in a H 2+T 2 gas-fueled implosion for the first time. Then, using multiple detectors with varied Cherenkov thresholds, we demonstrate a technique for simultaneously measuring both the HT and DT burn histories from an implosion where the total reaction yields are comparable. This new technique will be used to study material mixing and kinetic phenomena in implosions.

Simultaneous measurement of the HT and DT fusion burn histories in inertial fusion implosions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zylstra, Alex B.; Herrmann, Hans W.; Kim, Yong Ho

Measuring the thermonuclear burn history is an important way to diagnose inertial fusion implosions. Here, using the gas Cherenkov detectors at the OMEGA laser facility, we measure the HT fusion burn in a H 2+T 2 gas-fueled implosion for the first time. Then, using multiple detectors with varied Cherenkov thresholds, we demonstrate a technique for simultaneously measuring both the HT and DT burn histories from an implosion where the total reaction yields are comparable. This new technique will be used to study material mixing and kinetic phenomena in implosions.

Structural Pattern Recognition Techniques for Data Retrieval in Massive Fusion Databases

NASA Astrophysics Data System (ADS)

Vega, J.; Murari, A.; Rattá, G. A.; Castro, P.; Pereira, A.; Portas, A.

2008-03-01

Diagnostics of present day reactor class fusion experiments, like the Joint European Torus (JET), generate thousands of signals (time series and video images) in each discharge. There is a direct correspondence between the physical phenomena taking place in the plasma and the set of structural shapes (patterns) that they form in the signals: bumps, unexpected amplitude changes, abrupt peaks, periodic components, high intensity zones or specific edge contours. A major difficulty related to data analysis is the identification, in a rapid and automated way, of a set of discharges with comparable behavior, i.e. discharges with "similar" patterns. Pattern recognition techniques are efficient tools to search for similar structural forms within the database in a fast an intelligent way. To this end, classification systems must be developed to be used as indexation methods to directly fetch the more similar patterns.

Four-corner fusion: comparison of patient satisfaction and functional outcome of conventional K-wire technique vs. a new locking plate.

PubMed

Hernekamp, J F; Reinecke, A; Neubrech, F; Bickert, B; Kneser, U; Kremer, T

2016-04-01

Four-corner fusion is a standard procedure for advanced carpal collapse. Several operative techniques and numerous implants for osseous fixation have been described. Recently, a specially designed locking plate (Aptus©, Medartis, Basel, Switzerland) was introduced. The purpose of this study was to compare functional results after osseous fixation using K-wires (standard of care, SOC) with four-corner fusion and locking plate fixation. 21 patients who underwent four-corner fusion in our institution between 2008 and 2013 were included in a retrospective analysis. In 11 patients, osseous fixation was performed using locking plates whereas ten patients underwent bone fixation with conventional K-wires. Outcome parameters were functional outcome, osseous consolidation, patient satisfaction (DASH- and Krimmer Score), pain and perioperative morbidity and the time until patients returned to daily work. Patients were divided in two groups and paired t-tests were performed for statistical analysis. No implant related complications were observed. Osseous consolidation was achieved in all cases. Differences between groups were not significant regarding active range of motion (AROM), pain and function. Overall patient satisfaction was acceptable in all cases; differences in the DASH questionnaire and the Krimmer questionnaire were not significant. One patient of the plate group required conversion to total wrist arthrodesis without implant-related complications. Both techniques for four-corner fusion have similar healing rates. Using the more expensive locking implant avoids a second operation for K-wire removal, but no statistical differences were detected in functional outcome as well as in patient satisfaction when compared to SOC.

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

Laparoscopic bone dowel fusions of the lumbar spine.

PubMed

Silcox, D H

1998-10-01

Studies that show laparoscopic lumbar fusion to decrease cost or time of hospitalization or to increase the speed or incidence of return to activities are not currently available. Laparoscopic fusion of the lumbar spine appears to be a potentially attractive approach to treating axial back pain secondary to different causes. Although the technique is attractive because of its minimally invasive nature and marketing allure, it has yet to be established as to what the true clinical efficacy of this procedure will be. Further clinical study of these techniques with longer follow-up, and case-controlled studies should help clinicians to know the best fusion technique to offer patients.

Nonintrusive multibiometrics on a mobile device: a comparison of fusion techniques

NASA Astrophysics Data System (ADS)

Allano, Lorene; Morris, Andrew C.; Sellahewa, Harin; Garcia-Salicetti, Sonia; Koreman, Jacques; Jassim, Sabah; Ly-Van, Bao; Wu, Dalei; Dorizzi, Bernadette

2006-04-01

In this article we test a number of score fusion methods for the purpose of multimodal biometric authentication. These tests were made for the SecurePhone project, whose aim is to develop a prototype mobile communication system enabling biometrically authenticated users to deal legally binding m-contracts during a mobile phone call on a PDA. The three biometrics of voice, face and signature were selected because they are all traditional non-intrusive and easy to use means of authentication which can readily be captured on a PDA. By combining multiple biometrics of relatively low security it may be possible to obtain a combined level of security which is at least as high as that provided by a PIN or handwritten signature, traditionally used for user authentication. As the relative success of different fusion methods depends on the database used and tests made, the database we used was recorded on a suitable PDA (the Qtek2020) and the test protocol was designed to reflect the intended application scenario, which is expected to use short text prompts. Not all of the fusion methods tested are original. They were selected for their suitability for implementation within the constraints imposed by the application. All of the methods tested are based on fusion of the match scores output by each modality. Though computationally simple, the methods tested have shown very promising results. All of the 4 fusion methods tested obtain a significant performance increase.

Technique tip: use of anterior cruciate ligament jig for hindfoot fusion by calcanio-talo-tibial nail.

PubMed

Haque, Syed; Sarkar, Jay

2012-08-01

The use of intramedullary nail fixation for tibio-talo-calcaneal fusion is gaining popularity. There is chance of failure of procedure following faulty operative technique specially alignment. The article describes a useful application of tibial tunnel jig in inserting the calcanio-talo-tibial guide wire. There is precision of few millimeters in the exit point of guide wire on talus. The authors believe that this helps in better positioning of nail and hence better alignment and better operative outcome.

Mass Producing Targets for Nuclear Fusion

NASA Technical Reports Server (NTRS)

Wang, T. G.; Elleman, D. D.; Kendall, J. M.

1983-01-01

Metal-encapsulating technique advances prospects of controlling nuclear fusion. Prefilled fusion targets form at nozzle as molten metal such as tin flows through outer channel and pressurized deuterium/tritium gas flows through inner channel. Molten metal completely encloses gas charge as it drops off nozzle.

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.

Segmentation of lung nodules in computed tomography images using dynamic programming and multidirection fusion techniques.

PubMed

Wang, Qian; Song, Enmin; Jin, Renchao; Han, Ping; Wang, Xiaotong; Zhou, Yanying; Zeng, Jianchao

2009-06-01

The aim of this study was to develop a novel algorithm for segmenting lung nodules on three-dimensional (3D) computed tomographic images to improve the performance of computer-aided diagnosis (CAD) systems. The database used in this study consists of two data sets obtained from the Lung Imaging Database Consortium. The first data set, containing 23 nodules (22% irregular nodules, 13% nonsolid nodules, 17% nodules attached to other structures), was used for training. The second data set, containing 64 nodules (37% irregular nodules, 40% nonsolid nodules, 62% nodules attached to other structures), was used for testing. Two key techniques were developed in the segmentation algorithm: (1) a 3D extended dynamic programming model, with a newly defined internal cost function based on the information between adjacent slices, allowing parameters to be adapted to each slice, and (2) a multidirection fusion technique, which makes use of the complementary relationships among different directions to improve the final segmentation accuracy. The performance of this approach was evaluated by the overlap criterion, complemented by the true-positive fraction and the false-positive fraction criteria. The mean values of the overlap, true-positive fraction, and false-positive fraction for the first data set achieved using the segmentation scheme were 66%, 75%, and 15%, respectively, and the corresponding values for the second data set were 58%, 71%, and 22%, respectively. The experimental results indicate that this segmentation scheme can achieve better performance for nodule segmentation than two existing algorithms reported in the literature. The proposed 3D extended dynamic programming model is an effective way to segment sequential images of lung nodules. The proposed multidirection fusion technique is capable of reducing segmentation errors especially for no-nodule and near-end slices, thus resulting in better overall performance.

Arthroscopic partial wrist fusion.

PubMed

Ho, Pak-Cheong

2008-12-01

The wide intraarticular exposure of the wrist joint under arthroscopic view provides an excellent ground for various forms of partial wrist fusion. Combining with percutaneous fixation technique, arthroscopic partial wrist fusion can potentially generate the best possible functional outcome by preserving the maximal motion pertained with each type of partial wrist fusion because the effect of extraarticular adhesion associated with open surgery can be minimized. From November 1997 to May 2008, the author had performed 12 cases of arthroscopic partial wrist fusion, including scaphotrapeziotrapezoid fusion in 3, scaphoidectomy and 4-corner fusion in 4, radioscapholunate fusion in 3, radiolunate fusion in 1, and lunotriquetral fusion in 1 case. Through the radiocarpal or midcarpal joint, the corresponding articular surfaces were denuded of cartilage using arthroscopic burr and curette. Carpal bones involved in the fusion process were then transfixed with K wires percutaneously after alignment corrected and confirmed under fluoroscopic control. Autogenous cancellous bone graft or bone substitute were inserted and impacted to the fusion site through cannula under direct arthroscopic view. Final fixation could be by multiple K wires or cannulated screw system. Early mobilization was encouraged. Surgical complications were minor, including pin tract infection, skin burn, and delay union in 1 case. Uneventful radiologic union was obtained in 9 cases, stable fibrous union in 2, and nonunion in 1. The average follow-up period was 70 months. Symptom was resolved or improved, and functional motion was gained in all cases. All surgical scars were almost invisible, and aesthetic outcome was excellent.

Optical Design And Analysis Of Carbon Dioxide Laser Fusion Systems Using Interferometry And Fast Fourier Transform Techniques

NASA Astrophysics Data System (ADS)

Viswanathan, V. K.

1980-11-01

The optical design and analysis of the LASL carbon dioxide laser fusion systems required the use of techniques that are quite different from the currently used method in conventional optical design problems. The necessity for this is explored and the method that has been successfully used at Los Alamos to understand these systems is discussed with examples. This method involves characterization of the various optical components in their mounts by a Zernike polynomial set and using fast Fourier transform techniques to propagate the beam, taking diffraction and other nonlinear effects that occur in these types of systems into account. The various programs used for analysis are briefly discussed.

Seismic data fusion anomaly detection

NASA Astrophysics Data System (ADS)

Harrity, Kyle; Blasch, Erik; Alford, Mark; Ezekiel, Soundararajan; Ferris, David

2014-06-01

Detecting anomalies in non-stationary signals has valuable applications in many fields including medicine and meteorology. These include uses such as identifying possible heart conditions from an Electrocardiography (ECG) signals or predicting earthquakes via seismographic data. Over the many choices of anomaly detection algorithms, it is important to compare possible methods. In this paper, we examine and compare two approaches to anomaly detection and see how data fusion methods may improve performance. The first approach involves using an artificial neural network (ANN) to detect anomalies in a wavelet de-noised signal. The other method uses a perspective neural network (PNN) to analyze an arbitrary number of "perspectives" or transformations of the observed signal for anomalies. Possible perspectives may include wavelet de-noising, Fourier transform, peak-filtering, etc.. In order to evaluate these techniques via signal fusion metrics, we must apply signal preprocessing techniques such as de-noising methods to the original signal and then use a neural network to find anomalies in the generated signal. From this secondary result it is possible to use data fusion techniques that can be evaluated via existing data fusion metrics for single and multiple perspectives. The result will show which anomaly detection method, according to the metrics, is better suited overall for anomaly detection applications. The method used in this study could be applied to compare other signal processing algorithms.

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.

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.

An enhanced approach for biomedical image restoration using image fusion techniques

NASA Astrophysics Data System (ADS)

Karam, Ghada Sabah; Abbas, Fatma Ismail; Abood, Ziad M.; Kadhim, Kadhim K.; Karam, Nada S.

2018-05-01

Biomedical image is generally noisy and little blur due to the physical mechanisms of the acquisition process, so one of the common degradations in biomedical image is their noise and poor contrast. The idea of biomedical image enhancement is to improve the quality of the image for early diagnosis. In this paper we are using Wavelet Transformation to remove the Gaussian noise from biomedical images: Positron Emission Tomography (PET) image and Radiography (Radio) image, in different color spaces (RGB, HSV, YCbCr), and we perform the fusion of the denoised images resulting from the above denoising techniques using add image method. Then some quantive performance metrics such as signal -to -noise ratio (SNR), peak signal-to-noise ratio (PSNR), and Mean Square Error (MSE), etc. are computed. Since this statistical measurement helps in the assessment of fidelity and image quality. The results showed that our approach can be applied of Image types of color spaces for biomedical images.

Assessment of NDE Methods to Detect Lack of Fusion in HDPE Butt Fusion Joints

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, Susan L.; Doctor, Steven R.; Cinson, Anthony D.

2011-07-31

Studies at the Pacific Northwest National Laboratory (PNNL) in Richland, Washington, were conducted to evaluate nondestructive examinations (NDE) coupled with mechanical testing of butt fusion joints in high-density polyethylene (HDPE) pipe for assessing lack of fusion. The work provided information to the United States Nuclear Regulatory Commission (NRC) on the effectiveness of volumetric inspection techniques of HDPE butt fusion joints in Section III, Division 1, Class 3, buried piping systems in nuclear power plants. This paper describes results from assessments using ultrasonic and microwave nondestructive techniques and mechanical testing with the high-speed tensile impact test and the side-bend test formore » determining joint integrity. A series of butt joints were fabricated in 3408, 12-inch (30.5-cm) IPS DR-11 HDPE material by varying the fusion parameters to create good joints and joints containing a range of lack-of-fusion conditions. Six of these butt joints were volumetrically examined with time-of-flight diffraction (TOFD), phased-array (PA) ultrasound, and the Evisive microwave system. The outer diameter (OD) weld beads were removed for microwave evaluation and the pipes ultrasonically re-evaluated. In two of the six pipes, both the outer and inner diameter (ID) weld beads were removed and the pipe joints re-evaluated. Some of the pipes were sectioned and the joints destructively evaluated with the high-speed tensile test and the side-bend test. The fusion parameters, nondestructive and destructive evaluation results have been correlated to validate the effectiveness of what each NDE technology detects and what each does not detect. There was no single NDE method that detected all of the lack-of-fusion flaws but a combination of NDE methods did detect most of the flaws.« less

Subtalar fusion for pes valgus in cerebral palsy: results of a modified technique in the setting of single event multilevel surgery.

PubMed

Shore, Benjamin J; Smith, Katherine R; Riazi, Arash; Symons, Sean B V; Khot, Abhay; Graham, Kerr

2013-06-01

We studied the use of cortico-cancellous circular allograft combined with cannulated screw fixation for the correction of dorsolateral peritalar subluxation in a series of children with bilateral spastic cerebral palsy undergoing single event multilevel surgery. Forty-six children who underwent bilateral subtalar fusion between January 1999 and December 2004 were retrospectively reviewed. Gait laboratory records, Gross Motor Function Classification System (GMFCS) levels, Functional Mobility Scale (FMS) scores, and radiographs were reviewed. The surgical technique used an Ollier type incision with a precut cortico-cancellous allograft press-fit into the prepared sinus tarsi. One or two 7.3 mm fully threaded cancellous screws were used to fix the subtalar joint. Radiographic analysis included preoperative and postoperative standing lateral radiographs measuring the lateral talocalcaneal angle, lateral talo-first metatarsal angle, and navicular cuboid overlap. Fusion rate was assessed with radiographs >12 months after surgery. The mean patient age was 12.9 years (range, 7.8 to 18.4 y) with an average follow-up of 55 months. Statistically significant improvement postoperatively was found for all 3 radiographic indices: lateral talocalcaneal angle, mean improvement 20 degrees (95% CI, 17.5-22.1; P<0.001); lateral talo-first metatarsal angle, mean improvement 21 degrees (95% CI, 19.2-23.4; P<0.001); and navicular cuboid overlap, mean improvement 29% (95% CI, 25.7%-32.6%; P<0.001). FMS improved across all patients, with Gross Motor Function Classification System III children experiencing a 70% improvement across all 3 FMS distances (5, 50, and 500 m). All 3 radiographic measures improved significantly (P<0.001). Fusion was achieved in 45 patients and there were no wound complications. With this study, we demonstrate significant improvement in radiographic segmental alignment and overall function outcome with this modified subtalar fusion technique. We conclude that this

The use of 3D image fusion for percutaneous transluminal angioplasty and stenting of iliac artery obstructions: validation of the technique and systematic review of literature.

PubMed

Goudeketting, Seline R; Heinen, Stefan G; van den Heuvel, Daniel A; van Strijen, Marco J; de Haan, Michiel W; Slump, Cornelis H; de Vries, Jean-Paul P

2018-02-01

The effect of the insertion of guidewires and catheters on fusion accuracy of the three-dimensional (3D) image fusion technique during iliac percutaneous transluminal angioplasty (PTA) procedures has not yet been investigated. Technical validation of the 3D fusion technique was evaluated in 11 patients with common and/or external iliac artery lesions. A preprocedural contrast-enhanced magnetic resonance angiogram (CE-MRA) was segmented and manually registered to a cone-beam computed tomography image created at the beginning of the procedure for each patient. The treating physician visually scored the fusion accuracy (i.e., accurate [<2 mm], mismatch [2-5 mm], or inaccurate [>5 mm]) of the entire vasculature of the overlay with respect to the digital subtraction angiography (DSA) directly after the first obtained DSA. Contours of the vasculature of the fusion images and DSAs were drawn after the procedure. The cranial-caudal, lateral-medial, and absolute displacement were calculated between the vessel centerlines. To determine the influence of the catheters, displacement of the catheterized iliac trajectories were compared with the noncatheterized trajectories. Electronic databases were systematically searched for available literature published between January 2010 till August 2017. The mean registration error for all iliac trajectories (N.=20) was small (4.0±2.5 mm). No significant difference in fusion displacement was observed between catheterized (N.=11) and noncatheterized (N.=9) iliac arteries. The systematic literature search yielded 2 manuscripts with a total of 22 patients. The methodological quality of these studies was poor (≤11 MINORS Score), mainly due to a lack of a control group. Accurate image fusion based on preprocedural CE-MRA is possible and could potentially be of help in iliac PTA procedures. The flexible guidewires and angiographic catheters, routinely used during endovascular procedures of iliac arteries, did not cause significant

Gradient-based multiresolution image fusion.

PubMed

Petrović, Valdimir S; Xydeas, Costas S

2004-02-01

A novel approach to multiresolution signal-level image fusion is presented for accurately transferring visual information from any number of input image signals, into a single fused image without loss of information or the introduction of distortion. The proposed system uses a "fuse-then-decompose" technique realized through a novel, fusion/decomposition system architecture. In particular, information fusion is performed on a multiresolution gradient map representation domain of image signal information. At each resolution, input images are represented as gradient maps and combined to produce new, fused gradient maps. Fused gradient map signals are processed, using gradient filters derived from high-pass quadrature mirror filters to yield a fused multiresolution pyramid representation. The fused output image is obtained by applying, on the fused pyramid, a reconstruction process that is analogous to that of conventional discrete wavelet transform. This new gradient fusion significantly reduces the amount of distortion artefacts and the loss of contrast information usually observed in fused images obtained from conventional multiresolution fusion schemes. This is because fusion in the gradient map domain significantly improves the reliability of the feature selection and information fusion processes. Fusion performance is evaluated through informal visual inspection and subjective psychometric preference tests, as well as objective fusion performance measurements. Results clearly demonstrate the superiority of this new approach when compared to conventional fusion systems.

Occipitocervical fusions in children. Retrospective analysis and technical considerations.

PubMed

Rodgers, W B; Coran, D L; Emans, J B; Hresko, M T; Hall, J E

1999-07-01

This report presents a retrospective analysis of the authors' experience with occipitocervical fusions in children and adolescents during the last 2 decades. A description of an operative technique devised by the senior author (JEH), and a comparison of the results using this and other methods of fusion are given. Twenty-three patients underwent occipitocervical fusion. Fifteen of the patients were operated on using the authors' technique. To achieve stable fixation of the distal cervical vertebra a threaded Kirschner wire was passed transversely through the spinous process; occipital fixation was achieved by the traditional method of wiring corticocancellous bone graft to the skull through burr holes. The occipital wires then were wrapped around the Kirschner wire and the graft was cradled in the resulting nest. Halo immobilization was used in 10 patients for an average of 12.5 weeks (range, 6-24 weeks). Twenty-two patients achieved successful fusion at an average followup of 5.8 years (range, 1-14.33 years). Several complications, including transient quadriplegia in one patient, pseudarthrosis in two (one of which persists), hardware fixation failure in one, unintended distal extension of the fusion, pneumonia, wound infection, halo pin infection, skin breakdown under the halo vest, hydrocephalus, cerebrospinal fluid leak, and traumatic fusion fracture were encountered. Results using the technique described herein are comparable with or better than the results reported in the previous literature, and the results of the patients in this series in whom the technique was not used.

Development of a fusion approach selection tool

NASA Astrophysics Data System (ADS)

Pohl, C.; Zeng, Y.

2015-06-01

During the last decades number and quality of available remote sensing satellite sensors for Earth observation has grown significantly. The amount of available multi-sensor images along with their increased spatial and spectral resolution provides new challenges to Earth scientists. With a Fusion Approach Selection Tool (FAST) the remote sensing community would obtain access to an optimized and improved image processing technology. Remote sensing image fusion is a mean to produce images containing information that is not inherent in the single image alone. In the meantime the user has access to sophisticated commercialized image fusion techniques plus the option to tune the parameters of each individual technique to match the anticipated application. This leaves the operator with an uncountable number of options to combine remote sensing images, not talking about the selection of the appropriate images, resolution and bands. Image fusion can be a machine and time-consuming endeavour. In addition it requires knowledge about remote sensing, image fusion, digital image processing and the application. FAST shall provide the user with a quick overview of processing flows to choose from to reach the target. FAST will ask for available images, application parameters and desired information to process this input to come out with a workflow to quickly obtain the best results. It will optimize data and image fusion techniques. It provides an overview on the possible results from which the user can choose the best. FAST will enable even inexperienced users to use advanced processing methods to maximize the benefit of multi-sensor image exploitation.

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

Degenerative lumbar scoliosis in elderly patients: dynamic stabilization without fusion versus posterior instrumented fusion.

PubMed

Di Silvestre, Mario; Lolli, Francesco; Bakaloudis, Georgios

2014-01-01

Posterolateral fusion with pedicle screw instrumentation is currently the most widely accepted technique for degenerative lumbar scoliosis in elderly patients. However, a high incidence of complications has been reported in most series. Dynamic stabilization without fusion in patients older than 60 years has not previously been compared with the use of posterior fusion in degenerative lumbar scoliosis. To compare dynamic stabilization without fusion and posterior instrumented fusion in the treatment of degenerative lumbar scoliosis in elderly patients, in terms of perioperative findings, clinical outcomes, and adverse events. A retrospective study. Fifty-seven elderly patients were included. There were 45 women (78%) and 12 men (22%) with a mean age of 68.1 years (range, 61-78 years). All patients had degenerative de novo lumbar scoliosis, associated with vertebral canal stenosis in 51 cases (89.4%) and degenerative spondylolisthesis in 24 patients (42.1%). Clinical (Oswestry Disability Index, visual analog scale, Roland-Morris Disability Questionnaire) and radiological (scoliosis and lordosis corrections) outcomes as well as incidence of complications. Patients were divided into two groups: 32 patients (dynamic group) had dynamic stabilization without fusion and 25 patients (fusion group) underwent posterior instrumented fusion. All the patients' medical records and X-rays were reviewed. Preoperative, postoperative, and follow-up questionnaires were obtained to evaluate clinical outcomes. At an average follow-up of 64 months (range, 42-90 months), clinical results improved similarly in both groups of patients. Statistically superior scoliosis and final lordosis corrections were achieved with posterior fusion (56.9% vs. 37.3% and -46.8° vs. -35.8°, respectively). However, in the dynamic group, incidence of overall complications was lower (25% vs. 44%), and fewer patients required revision surgery (6.2% vs. 16%). Furthermore, lower average values of operative

Does Lordotic Angle of Cage Determine Lumbar Lordosis in Lumbar Interbody Fusion?

PubMed

Hong, Taek-Ho; Cho, Kyu-Jung; Kim, Young-Tae; Park, Jae-Woo; Seo, Beom-Ho; Kim, Nak-Chul

2017-07-01

Retrospective, radiological analysis. To determine that 15° lordotic angle cages create higher lumbar lordosis in open transforaminal lumbar interbody fusion (TLIF) than 4° and 8° cages. Restoration of lumbar lordosis is important to obtain good outcome after lumbar fusion surgery. Various shapes and angles of cages in interbody fusion have been used; however, it is not proved that lordotic angle of cages determine lumbar lordosis. Sixty-seven patients were evaluated after TLIF using 15° cages and screw instrumentation. For comparison, TLIF using 4° lordotic angle cages in 65 patients and 8° cages in 49 patients were analyzed. Lumbar lordosis angles, segmental lordosis angles, disc height, and bony union rate were measured on the radiographs. The lumbar lordosis was 31.1° preoperatively, improved to 42.9° postoperatively, and decreased to 36.4° at the last follow-up in the 15° group. It was 35.8° before surgery, corrected to 41.5° after surgery, and changed to 33.6° at the last follow-up in the 4° group. In the 8° group, it was 32.7° preoperatively, improved to 39.1° postoperatively, and decreased to 34.5° at the last follow-up. These changes showed statistical significances (P < 0.001). The segmental lordosis at L4-5 was 6.6° before surgery, 13.1° after surgery, and 9.8° at the last follow-up in the 15° group. It was 6.9°, 9.5°, and 6.2° in the 4° group and 6.7°, 9.8°, and 8.1° in the 8° group, respectively (P < 0.001). The disc height restoration was better in the 15° group than in the 4° and 8° groups (P < 0.001). Bony union rate was not significant among the three groups (P = 0.087). The lordotic angle of the cages determined restoration of lumbar lordosis after TLIF. Cages with sufficient lordotic angle showed better restoration of lumbar lordosis and prevention of loss of correction. 4.

Covariance descriptor fusion for target detection

NASA Astrophysics Data System (ADS)

Cukur, Huseyin; Binol, Hamidullah; Bal, Abdullah; Yavuz, Fatih

2016-05-01

Target detection is one of the most important topics for military or civilian applications. In order to address such detection tasks, hyperspectral imaging sensors provide useful images data containing both spatial and spectral information. Target detection has various challenging scenarios for hyperspectral images. To overcome these challenges, covariance descriptor presents many advantages. Detection capability of the conventional covariance descriptor technique can be improved by fusion methods. In this paper, hyperspectral bands are clustered according to inter-bands correlation. Target detection is then realized by fusion of covariance descriptor results based on the band clusters. The proposed combination technique is denoted Covariance Descriptor Fusion (CDF). The efficiency of the CDF is evaluated by applying to hyperspectral imagery to detect man-made objects. The obtained results show that the CDF presents better performance than the conventional covariance descriptor.

Fusion or confusion: knowledge or nonsense?

NASA Astrophysics Data System (ADS)

Rothman, Peter L.; Denton, Richard V.

1991-08-01

The terms 'data fusion,' 'sensor fusion,' multi-sensor integration,' and 'multi-source integration' have been used widely in the technical literature to refer to a variety of techniques, technologies, systems, and applications which employ and/or combine data derived from multiple information sources. Applications of data fusion range from real-time fusion of sensor information for the navigation of mobile robots to the off-line fusion of both human and technical strategic intelligence data. The Department of Defense Critical Technologies Plan lists data fusion in the highest priority group of critical technologies, but just what is data fusion? The DoD Critical Technologies Plan states that data fusion involves 'the acquisition, integration, filtering, correlation, and synthesis of useful data from diverse sources for the purposes of situation/environment assessment, planning, detecting, verifying, diagnosing problems, aiding tactical and strategic decisions, and improving system performance and utility.' More simply states, sensor fusion refers to the combination of data from multiple sources to provide enhanced information quality and availability over that which is available from any individual source alone. This paper presents a survey of the state-of-the- art in data fusion technologies, system components, and applications. A set of characteristics which can be utilized to classify data fusion systems is presented. Additionally, a unifying mathematical and conceptual framework within which to understand and organize fusion technologies is described. A discussion of often overlooked issues in the development of sensor fusion systems is also presented.

Multimodality Inferring of Human Cognitive States Based on Integration of Neuro-Fuzzy Network and Information Fusion Techniques

NASA Astrophysics Data System (ADS)

Yang, G.; Lin, Y.; Bhattacharya, P.

2007-12-01

To achieve an effective and safe operation on the machine system where the human interacts with the machine mutually, there is a need for the machine to understand the human state, especially cognitive state, when the human's operation task demands an intensive cognitive activity. Due to a well-known fact with the human being, a highly uncertain cognitive state and behavior as well as expressions or cues, the recent trend to infer the human state is to consider multimodality features of the human operator. In this paper, we present a method for multimodality inferring of human cognitive states by integrating neuro-fuzzy network and information fusion techniques. To demonstrate the effectiveness of this method, we take the driver fatigue detection as an example. The proposed method has, in particular, the following new features. First, human expressions are classified into four categories: (i) casual or contextual feature, (ii) contact feature, (iii) contactless feature, and (iv) performance feature. Second, the fuzzy neural network technique, in particular Takagi-Sugeno-Kang (TSK) model, is employed to cope with uncertain behaviors. Third, the sensor fusion technique, in particular ordered weighted aggregation (OWA), is integrated with the TSK model in such a way that cues are taken as inputs to the TSK model, and then the outputs of the TSK are fused by the OWA which gives outputs corresponding to particular cognitive states under interest (e.g., fatigue). We call this method TSK-OWA. Validation of the TSK-OWA, performed in the Northeastern University vehicle drive simulator, has shown that the proposed method is promising to be a general tool for human cognitive state inferring and a special tool for the driver fatigue detection.

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.

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.

Sensor data fusion for spectroscopy-based detection of explosives

NASA Astrophysics Data System (ADS)

Shah, Pratik V.; Singh, Abhijeet; Agarwal, Sanjeev; Sedigh, Sahra; Ford, Alan; Waterbury, Robert

2009-05-01

In-situ trace detection of explosive compounds such as RDX, TNT, and ammonium nitrate, is an important problem for the detection of IEDs and IED precursors. Spectroscopic techniques such as LIBS and Raman have shown promise for the detection of residues of explosive compounds on surfaces from standoff distances. Individually, both LIBS and Raman techniques suffer from various limitations, e.g., their robustness and reliability suffers due to variations in peak strengths and locations. However, the orthogonal nature of the spectral and compositional information provided by these techniques makes them suitable candidates for the use of sensor fusion to improve the overall detection performance. In this paper, we utilize peak energies in a region by fitting Lorentzian or Gaussian peaks around the location of interest. The ratios of peak energies are used for discrimination, in order to normalize the effect of changes in overall signal strength. Two data fusion techniques are discussed in this paper. Multi-spot fusion is performed on a set of independent samples from the same region based on the maximum likelihood formulation. Furthermore, the results from LIBS and Raman sensors are fused using linear discriminators. Improved detection performance with significantly reduced false alarm rates is reported using fusion techniques on data collected for sponsor demonstration at Fort Leonard Wood.

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.

Surgical technique for balancing posterior spinal fusions to the pelvis using the T square of Tolo.

PubMed

Andras, Lindsay; Yamaguchi, Kent T; Skaggs, David L; Tolo, Vernon T

2012-12-01

Correcting pelvic obliquity and improving sitting balance in neuromuscular scoliosis often requires fixation to the pelvis. We describe the use of a T square instrument to assist intraoperatively in evaluating the alignment of these curves and achieving balance in the coronal plane. The T square instrument was constructed with a vertical limb perpendicular to 2 horizontal limbs in a T formation. At the conclusion of the instrumentation and preliminary reduction maneuvers, the T square was positioned with the horizontal limbs parallel to the pelvis and the vertical limb in line with the central sacral line. If the spine and pelvis were well balanced, fluoroscopic images demonstrated that the superior aspect of the vertical limb of the T square was crossing the vertebral body of T1. If this was not shown, then some combination of compression, distraction, or a change in the contouring of the rods was performed until this balance was achieved. In this series, we describe case examples in which the T square has been successfully used to aid in achieving balance in the coronal plane. This technique helps to overcome the challenges with positioning and imaging often encountered in managing these long, rigid curves. The T square is a useful adjunct in balancing posterior spinal fusions and evaluating the correction of pelvic obliquity in cases of neuromuscular scoliosis. This novel, yet simple, T square technique can be used for any method of posterior spinal fusion with lumbopelvic fixation to assist in the intraoperative evaluation and achievement of balance in the coronal plane and has become routine at our institution. IV.

Imaging Determinants of Clinical Effectiveness of Lumbar Transforaminal Epidural Steroid Injections.

PubMed

Maus, Timothy P; El-Yahchouchi, Christine A; Geske, Jennifer R; Carter, Rickey E; Kaufmann, Timothy J; Wald, John T; Diehn, Felix E

2016-12-01

To examine associations between imaging characteristics of compressive lesions and patient outcomes after lumbar transforaminal epidural steroid injections (TFESIs) stratified by steroid formulation (solution versus suspension). Retrospective observational study, academic radiology practice. A 516-patient sample was selected from 2,634 consecutive patients receiving lumbar TFESI for radicular pain. The advanced imaging study(s) preceding sampled TFESI were reviewed. Compressive lesions were described by a) nature of the lesion [disc herniation, fixed stenosis, synovial cyst, epidural fibrosis, no lesion] b) degree of neural compression [4 part scale], and c) presence of a tandem lesion. Associations between 2-month categorical outcomes (responder rates for pain, functional recovery) and imaging characteristics, stratified by steroid formulation, were examined with chi-squared tests of categorical outcomes and multivariable logistic regression models. Disc herniation patients had more responders for functional recovery than patients with fixed lesions (54% versus 38%, P = 0.01). Patients with fixed lesions receiving steroid solution (dexamethasone) had more responders for pain relief, with a similar trend for functional recovery, than patients receiving suspensions (59% versus 40%, P = 0.01). Outcomes for patients with fixed lesions treated with dexamethasone were not statistically different from those for disc herniation patients. Patients with single compressive lesions had more responders than those with tandem lesions (55% versus 41%, P = 0.03). In the entire sample, outcomes for disc herniations were more favorable than for fixed lesions. However, fixed lesions treated with dexamethasone had outcomes indistinguishable from disc herniations. Single lesions had better outcomes than tandem lesions. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Perspectives of SiC-Based Ceramic Composites and Their Applications to Fusion Reactors 5.Development of Evaluation and Application Techniques of SiC⁄SiC Composites for Fusion Reactors

NASA Astrophysics Data System (ADS)

Hinoki, Tatsuya

Evaluation techniques and mechanical properties of silicon carbide composites (SiC⁄SiC composites) reinforced with highly crystalline fibers are reviewed for fusion applications. The SiC⁄SiC composites used were fabricated by means of the CVI method. The evaluation includes in-plane tensile strength by in-plane tensile test, transthickness tensile strength by transthickness tensile test and diametral compression test and shear strength by compression test using double-notched specimen. All tests were successfully conducted using small specimens for neutron irradiation experiment. As application technique, the novel tungsten(W) coating technique on SiC is reviewed. The W powder melted by high power lamp in a few seconds and formed coating on SiC. No thick reaction layers of WC and W5Si3, which are formed by the other coating methods, were formed by this method.

Pedicle screw fixation for isthmic spondylolisthesis: does posterior lumbar interbody fusion improve outcome over posterolateral fusion?

PubMed

La Rosa, Giovanni; Conti, Alfredo; Cacciola, Fabio; Cardali, Salvatore; La Torre, Domenico; Gambadauro, Nicola Maria; Tomasello, Francesco

2003-09-01

Posterolateral fusion involving instrumentation-assisted segmental fixation represents a valid procedure in the treatment of lumbar instability. In cases of anterior column failure, such as in isthmic spondylolisthesis, supplemental posterior lumbar interbody fusion (PLIF) may improve the fusion rate and endurance of the construct. Posterior lumbar interbody fusion is, however, a more demanding procedure and increases costs and risks of the intervention. The advantages of this technique must, therefore, be weighed against those of a simple posterior lumbar fusion. Thirty-five consecutive patients underwent pedicle screw fixation for isthmic spondylolisthesis. In 18 patients posterior lumbar fusion was performed, and in 17 patients PLIF was added. Clinical, economic, functional, and radiographic data were assessed to determine differences in clinical and functional results and biomechanical properties. At 2-year follow-up examination, the correction of subluxation, disc height, and foraminal area were maintained in the group in which a PLIF procedure was performed, but not in the posterolateral fusion-only group (p < 0.05). Nevertheless, no statistical intergroup differences were demonstrated in terms of neurological improvement (p = 1), economic (p = 0.43), or functional (p = 0.95) outcome, nor in terms of fusion rate (p = 0.49). The authors' findings support the view that an interbody fusion confers superior mechanical strength to the spinal construct; when posterolateral fusion is the sole intervention, progressive loss of the extreme correction can be expected. Such mechanical insufficiency, however, did not influence clinical outcome.

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

Landcover classification in MRF context using Dempster-Shafer fusion for multisensor imagery.

PubMed

Sarkar, Anjan; Banerjee, Anjan; Banerjee, Nilanjan; Brahma, Siddhartha; Kartikeyan, B; Chakraborty, Manab; Majumder, K L

2005-05-01

This work deals with multisensor data fusion to obtain landcover classification. The role of feature-level fusion using the Dempster-Shafer rule and that of data-level fusion in the MRF context is studied in this paper to obtain an optimally segmented image. Subsequently, segments are validated and classification accuracy for the test data is evaluated. Two examples of data fusion of optical images and a synthetic aperture radar image are presented, each set having been acquired on different dates. Classification accuracies of the technique proposed are compared with those of some recent techniques in literature for the same image data.

Percutaneous endoscopic lumbar discectomy via contralateral approach: a technical case report.

PubMed

Kim, Jin-Sung; Choi, Gun; Lee, Sang-Ho

2011-08-01

Technical case report. The authors report a new percutaneous endoscopic lumbar discectomy (PELD) technique for the treatment of lumbar disc herniation via a contralateral approach. When there are highly down-migrated lumbar disc herniation along just medial to pedicle and narrow ipsilateral intervertebral foramen, the conventional PELD is not easily accessible via ipsilateral transforaminal route. Five patients manifested gluteal and leg pain because of a soft disc herniation at the L4-L5 level. Transforaminal PELD via a contralateral approach was performed to remove the herniated fragment, achieving complete decompression of the nerve root. The symptom was relieved and the patient was discharged the next day. When a conventional transforaminal PELD is difficult because of some anatomical reasons, PELD via a contralateral route could be a good alternative option in selected cases.

Fusion Energy Division progress report, 1 January 1990--31 December 1991

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheffield, J.; Baker, C.C.; Saltmarsh, M.J.

1994-03-01

The Fusion Program of the Oak Ridge National Laboratory (ORNL), a major part of the national fusion program, encompasses nearly all areas of magnetic fusion research. The program is directed toward the development of fusion as an economical and environmentally attractive energy source for the future. The program involves staff from ORNL, Martin Marietta Energy systems, Inc., private industry, the academic community, and other fusion laboratories, in the US and abroad. Achievements resulting from this collaboration are documented in this report, which is issued as the progress report of the ORNL Fusion Energy Division; it also contains information from componentsmore » for the Fusion Program that are external to the division (about 15% of the program effort). The areas addressed by the Fusion Program include the following: experimental and theoretical research on magnetic confinement concepts; engineering and physics of existing and planned devices, including remote handling; development and testing of diagnostic tools and techniques in support of experiments; assembly and distribution to the fusion community of databases on atomic physics and radiation effects; development and testing of technologies for heating and fueling fusion plasmas; development and testing of superconducting magnets for containing fusion plasmas; development and testing of materials for fusion devices; and exploration of opportunities to apply the unique skills, technology, and techniques developed in the course of this work to other areas (about 15% of the Division`s activities). Highlights from program activities during 1990 and 1991 are presented.« less

Single transverse-orientation cage via MIS-TLIF approach for the treatment of degenerative lumbar disease: a technical note.

PubMed

Wang, Shan-Jin; Han, Ying-Chao; Pan, Fu-Min; Ma, Bin; Tan, Jun

2015-01-01

Single transverse cage placed in the anterior vertebral column can better maintain lumbar lordosis and sagittal alignment and is frequently used via the lateral transpsoas approach. However, there is no clear description in the literature of the steps required to place the single transverse cage during the instrumented transforaminal lumbar interbody fusion (TLIF) procedure for the treatment of degenerative lumbar disease. The objective of this study is to describe the technique using single transverse-orientation cage when performing TLIF procedures. We present 18 illustrative cases in which single transverse-orientation cage was placed according to a step-by-step technique that can be used during the TLIF procedure. Information acquired included procedure time, intraoperative blood loss and postoperative complications. The preoperative and postoperative Oswestry Disability Index (ODI) and the visual analogue scale (VAS) scores were recorded. Changes in disc height and segmental lordosis were measured at radiographs. The single transverse-orientation cage was successfully placed in 18 patients in a stepwise technique to achieve lumbar fusion. Using this technique, the patients significantly improved clinically and radiographically at postoperative visits. This is the first report demonstrating the safety and efficacy of instrumented TLIF with single transverse-orientation cage for the treatment of degenerative lumbar disease. Single transverse-orientation cage via MIS-TLIF approach can maintain greater lumbar lordosis and avoid the unique complications of lateral transpsoas approach. Understanding the options for cage placement is important for surgeons considering the use of this technique.

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. Copyright © 2014 Elsevier B.V. All rights reserved.

Regional distribution of forest height and biomass from multisensor data fusion

Treesearch

Yifan Yu; Sassan Saatch; Linda S. Heath; Elizabeth LaPoint; Ranga Myneni; Yuri Knyazikhin

2010-01-01

Elevation data acquired from radar interferometry at C-band from SRTM are used in data fusion techniques to estimate regional scale forest height and aboveground live biomass (AGLB) over the state of Maine. Two fusion techniques have been developed to perform post-processing and parameter estimations from four data sets: 1 arc sec National Elevation Data (NED), SRTM...

Biomechanical advantages of robot-assisted pedicle screw fixation in posterior lumbar interbody fusion compared with freehand technique in a prospective randomized controlled trial-perspective for patient-specific finite element analysis.

PubMed

Kim, Ho-Joong; Kang, Kyoung-Tak; Park, Sung-Cheol; Kwon, Oh-Hyo; Son, Juhyun; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S; Lenke, Lawrence G

2017-05-01

There have been conflicting results on the surgical outcome of lumbar fusion surgery using two different techniques: robot-assisted pedicle screw fixation and conventional freehand technique. In addition, there have been no studies about the biomechanical issues between both techniques. This study aimed to investigate the biomechanical properties in terms of stress at adjacent segments using robot-assisted pedicle screw insertion technique (robot-assisted, minimally invasive posterior lumbar interbody fusion, Rom-PLIF) and freehand technique (conventional, freehand, open approach, posterior lumbar interbody fusion, Cop-PLIF) for instrumented lumbar fusion surgery. This is an additional post-hoc analysis for patient-specific finite element (FE) model. The sample is composed of patients with degenerative lumbar disease. Intradiscal pressure and facet contact force are the outcome measures. Patients were randomly assigned to undergo an instrumented PLIF procedure using a Rom-PLIF (37 patients) or a Cop-PLIF (41), respectively. Five patients in each group were selected using a simple random sampling method after operation, and 10 preoperative and postoperative lumbar spines were modeled from preoperative high-resolution computed tomography of 10 patients using the same method for a validated lumbar spine model. Under four pure moments of 7.5 Nm, the changes in intradiscal pressure and facet joint contact force at the proximal adjacent segment following fusion surgery were analyzed and compared with preoperative states. The representativeness of random samples was verified. Both groups showed significant increases in postoperative intradiscal pressure at the proximal adjacent segment under four moments, compared with the preoperative state. The Cop-PLIF models demonstrated significantly higher percent increments of intradiscal pressure at proximal adjacent segments under extension, lateral bending, and torsion moments than the Rom-PLIF models (p=.032, p=.008, and p

Influenza Virus-Mediated Membrane Fusion: Determinants of Hemagglutinin Fusogenic Activity and Experimental Approaches for Assessing Virus Fusion

PubMed Central

Hamilton, Brian S.; Whittaker, Gary R.; Daniel, Susan

2012-01-01

Hemagglutinin (HA) is the viral protein that facilitates the entry of influenza viruses into host cells. This protein controls two critical aspects of entry: virus binding and membrane fusion. In order for HA to carry out these functions, it must first undergo a priming step, proteolytic cleavage, which renders it fusion competent. Membrane fusion commences from inside the endosome after a drop in lumenal pH and an ensuing conformational change in HA that leads to the hemifusion of the outer membrane leaflets of the virus and endosome, the formation of a stalk between them, followed by pore formation. Thus, the fusion machinery is an excellent target for antiviral compounds, especially those that target the conserved stem region of the protein. However, traditional ensemble fusion assays provide a somewhat limited ability to directly quantify fusion partly due to the inherent averaging of individual fusion events resulting from experimental constraints. Inspired by the gains achieved by single molecule experiments and analysis of stochastic events, recently-developed individual virion imaging techniques and analysis of single fusion events has provided critical information about individual virion behavior, discriminated intermediate fusion steps within a single virion, and allowed the study of the overall population dynamics without the loss of discrete, individual information. In this article, we first start by reviewing the determinants of HA fusogenic activity and the viral entry process, highlight some open questions, and then describe the experimental approaches for assaying fusion that will be useful in developing the most effective therapies in the future. PMID:22852045

Semiotic foundation for multisensor-multilook fusion

NASA Astrophysics Data System (ADS)

Myler, Harley R.

1998-07-01

This paper explores the concept of an application of semiotic principles to the design of a multisensor-multilook fusion system. Semiotics is an approach to analysis that attempts to process media in a united way using qualitative methods as opposed to quantitative. The term semiotic refers to signs, or signatory data that encapsulates information. Semiotic analysis involves the extraction of signs from information sources and the subsequent processing of the signs into meaningful interpretations of the information content of the source. The multisensor fusion problem predicated on a semiotic system structure and incorporating semiotic analysis techniques is explored and the design for a multisensor system as an information fusion system is explored. Semiotic analysis opens the possibility of using non-traditional sensor sources and modalities in the fusion process, such as verbal and textual intelligence derived from human observers. Examples of how multisensor/multimodality data might be analyzed semiotically is shown and discussion on how a semiotic system for multisensor fusion could be realized is outlined. The architecture of a semiotic multisensor fusion processor that can accept situational awareness data is described, although an implementation has not as yet been constructed.

90-day Readmission After Lumbar Spinal Fusion Surgery in New York State Between 2005 and 2014: A 10-year Analysis of a Statewide Cohort.

PubMed

Baaj, Ali A; Lang, Gernot; Hsu, Wei-Chun; Avila, Mauricio J; Mao, Jialin; Sedrakyan, Art

2017-11-15

MINI: We assessed 90-day readmission and evaluated risk factors associated with readmission after lumbar spinal fusion surgery in New York State. The overall 90-day readmission rate was 24.8%. Age, sex, race, insurance, procedure, number of operated spinal levels, health service area, and comorbidities are major risk factors for 90-day readmission. Retrospective cohort study. The aim of this study was to assess 90-day readmission and evaluate risk factors associated with readmission after lumbar fusion in New York State. Readmission is becoming an important metric for quality and efficiency of health care. Readmission and its predictors following spine surgery are overall poorly understood and limited evidence is available specifically in lumbar fusion. The New York Statewide Planning and Research Cooperative System (SPARCS) was utilized to capture patients undergoing lumbar fusion from 2005 to 2014. Temporal trend of 90-day readmission was assessed using Cochran-Armitage test. Logistic regression was used to examine predictors associated with 90-day readmission. There were 86,869 patients included in this cohort study. The overall 90-day readmission rate was 24.8%. On a multivariable analysis model, age (odds ratio [OR] comparing ≥75 versus <35 years: 1.24, 95% confidence interval [CI]: 1.13-1.35), sex (OR female to male: 1.19, 95% CI: 1.15-1.23), race (OR African-American to white: 1.60, 95% CI: 1.52-1.69), insurance (OR Medicaid to Medicare: 1.42, 95% CI: 1.33-1.53), procedure (OR comparing thoracolumbar fusion, combined [International Classification of Disease, Ninth Revision, ICD-9: 81.04] to posterior lumbar interbody fusion/transforaminal lumbar spinal fusion [ICD-9: 81.08]: 2.10, 95% CI: 1.49-2.97), number of operated spinal levels (OR comparing four to eight vertebrae to two to three vertebrae: 2.39, 95% CI: 2.07-2.77), health service area ([HSA]; OR comparing Finger Lakes to New York-Pennsylvania border: 0.67, 95% CI: 0.61-0.73), and comorbidity, i

Proteins on exocytic vesicles mediate calcium-triggered fusion.

PubMed Central

Vogel, S S; Zimmerberg, J

1992-01-01

In many exocytic systems, micromolar concentrations of intracellular Ca2+ trigger fusion. We find that aggregates of secretory granules isolated from sea urchin eggs fuse together when perfused with greater than or equal to 10 microM free Ca2+. Mixing of membrane components was demonstrated by transfer of fluorescent lipophilic dye, and melding of granule contents was seen with differential interference microscopy. A technique based upon light scattering was developed to conveniently detect fusion. Two protein modifiers, trypsin and N-ethylmaleimide, inhibit granule-granule fusion at concentrations similar to those that inhibit granule-plasma membrane fusion. We suggest that molecular machinery sufficient for Ca(2+)-triggered fusion resides on secretory granules as purified and that at least some of these essential components are proteinaceous. Images PMID:1584814

Painful lumbosacral melorheostosis treated by fusion.

PubMed

Robertson, Peter A; Don, Angus S; Miller, Mary V

2003-06-15

A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine. To describe a rare presentation of melorheostosis and subsequent successful surgical treatment. Melorheostosis is a rare condition and spinal pain has not been described in association with the condition. A patient with disabling low back pain and suspected melorheostosis of the lumbosacral spine responded favorably to diagnostic facet joint blocks. Treatment was lumbosacral fusion and biopsy of the abnormal bone. The densely sclerotic bone presented technical difficulties requiring modification of surgical technique. Dramatic pain and disability reduction occurred following lumbosacral fusion. Histologic examination was consistent with melorheostosis. Melorheostosis rarely causes severe low back pain that can respond favorably to fusion surgery.

Feasibility of three-dimensional magnetic resonance angiography-fluoroscopy image fusion technique in guiding complex endovascular aortic procedures in patients with renal insufficiency.

PubMed

Schwein, Adeline; Chinnadurai, Ponraj; Shah, Dipan J; Lumsden, Alan B; Bechara, Carlos F; Bismuth, Jean

2017-05-01

Three-dimensional image fusion of preoperative computed tomography (CT) angiography with fluoroscopy using intraoperative noncontrast cone-beam CT (CBCT) has been shown to improve endovascular procedures by reducing procedure length, radiation dose, and contrast media volume. However, patients with a contraindication to CT angiography (renal insufficiency, iodinated contrast allergy) may not benefit from this image fusion technique. The primary objective of this study was to evaluate the feasibility of magnetic resonance angiography (MRA) and fluoroscopy image fusion using noncontrast CBCT as a guidance tool during complex endovascular aortic procedures, especially in patients with renal insufficiency. All endovascular aortic procedures done under MRA image fusion guidance at a single-center were retrospectively reviewed. The patients had moderate to severe renal insufficiency and underwent diagnostic contrast-enhanced magnetic resonance imaging after gadolinium or ferumoxytol injection. Relevant vascular landmarks electronically marked in MRA images were overlaid on real-time two-dimensional fluoroscopy for image guidance, after image fusion with noncontrast intraoperative CBCT. Technical success, time for image registration, procedure time, fluoroscopy time, number of digital subtraction angiography (DSA) acquisitions before stent deployment or vessel catheterization, and renal function before and after the procedure were recorded. The image fusion accuracy was qualitatively evaluated on a binary scale by three physicians after review of image data showing virtual landmarks from MRA on fluoroscopy. Between November 2012 and March 2016, 10 patients underwent endovascular procedures for aortoiliac aneurysmal disease or aortic dissection using MRA image fusion guidance. All procedures were technically successful. A paired t-test analysis showed no difference between preimaging and postoperative renal function (P = .6). The mean time required for MRA-CBCT image

Sensor fusion III: 3-D perception and recognition; Proceedings of the Meeting, Boston, MA, Nov. 5-8, 1990

NASA Technical Reports Server (NTRS)

Schenker, Paul S. (Editor)

1991-01-01

The volume on data fusion from multiple sources discusses fusing multiple views, temporal analysis and 3D motion interpretation, sensor fusion and eye-to-hand coordination, and integration in human shape perception. Attention is given to surface reconstruction, statistical methods in sensor fusion, fusing sensor data with environmental knowledge, computational models for sensor fusion, and evaluation and selection of sensor fusion techniques. Topics addressed include the structure of a scene from two and three projections, optical flow techniques for moving target detection, tactical sensor-based exploration in a robotic environment, and the fusion of human and machine skills for remote robotic operations. Also discussed are K-nearest-neighbor concepts for sensor fusion, surface reconstruction with discontinuities, a sensor-knowledge-command fusion paradigm for man-machine systems, coordinating sensing and local navigation, and terrain map matching using multisensing techniques for applications to autonomous vehicle navigation.

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

Spatial Statistical Data Fusion for Remote Sensing Applications

NASA Technical Reports Server (NTRS)

Nguyen, Hai

2010-01-01

Data fusion is the process of combining information from heterogeneous sources into a single composite picture of the relevant process, such that the composite picture is generally more accurate and complete than that derived from any single source alone. Data collection is often incomplete, sparse, and yields incompatible information. Fusion techniques can make optimal use of such data. When investment in data collection is high, fusion gives the best return. Our study uses data from two satellites: (1) Multiangle Imaging SpectroRadiometer (MISR), (2) Moderate Resolution Imaging Spectroradiometer (MODIS).

Multispectral multisensor image fusion using wavelet transforms

USGS Publications Warehouse

Lemeshewsky, George P.

1999-01-01

Fusion techniques can be applied to multispectral and higher spatial resolution panchromatic images to create a composite image that is easier to interpret than the individual images. Wavelet transform-based multisensor, multiresolution fusion (a type of band sharpening) was applied to Landsat thematic mapper (TM) multispectral and coregistered higher resolution SPOT panchromatic images. The objective was to obtain increased spatial resolution, false color composite products to support the interpretation of land cover types wherein the spectral characteristics of the imagery are preserved to provide the spectral clues needed for interpretation. Since the fusion process should not introduce artifacts, a shift invariant implementation of the discrete wavelet transform (SIDWT) was used. These results were compared with those using the shift variant, discrete wavelet transform (DWT). Overall, the process includes a hue, saturation, and value color space transform to minimize color changes, and a reported point-wise maximum selection rule to combine transform coefficients. The performance of fusion based on the SIDWT and DWT was evaluated with a simulated TM 30-m spatial resolution test image and a higher resolution reference. Simulated imagery was made by blurring higher resolution color-infrared photography with the TM sensors' point spread function. The SIDWT based technique produced imagery with fewer artifacts and lower error between fused images and the full resolution reference. Image examples with TM and SPOT 10-m panchromatic illustrate the reduction in artifacts due to the SIDWT based fusion.

Multi-atlas segmentation with joint label fusion and corrective learning—an open source implementation

PubMed Central

Wang, Hongzhi; Yushkevich, Paul A.

2013-01-01

Label fusion based multi-atlas segmentation has proven to be one of the most competitive techniques for medical image segmentation. This technique transfers segmentations from expert-labeled images, called atlases, to a novel image using deformable image registration. Errors produced by label transfer are further reduced by label fusion that combines the results produced by all atlases into a consensus solution. Among the proposed label fusion strategies, weighted voting with spatially varying weight distributions derived from atlas-target intensity similarity is a simple and highly effective label fusion technique. However, one limitation of most weighted voting methods is that the weights are computed independently for each atlas, without taking into account the fact that different atlases may produce similar label errors. To address this problem, we recently developed the joint label fusion technique and the corrective learning technique, which won the first place of the 2012 MICCAI Multi-Atlas Labeling Challenge and was one of the top performers in 2013 MICCAI Segmentation: Algorithms, Theory and Applications (SATA) challenge. To make our techniques more accessible to the scientific research community, we describe an Insight-Toolkit based open source implementation of our label fusion methods. Our implementation extends our methods to work with multi-modality imaging data and is more suitable for segmentation problems with multiple labels. We demonstrate the usage of our tools through applying them to the 2012 MICCAI Multi-Atlas Labeling Challenge brain image dataset and the 2013 SATA challenge canine leg image dataset. We report the best results on these two datasets so far. PMID:24319427

[Hybrid stabilization technique with spinal fusion and interlaminar device to reduce the length of fusion and to protect symptomatic adjacent segments : Clinical long-term follow-up].

PubMed

Fleege, C; Rickert, M; Werner, I; Rauschmann, M; Arabmotlagh, M

2016-09-01

Determination of the extent of spinal fusion for lumbar degenerative diseases is often difficult due to minor pathologies in the adjacent segment. Although surgical intervention is required, fusion seems to be an overtreatment. Decompression alone may be not enough as this segment is affected by multiple factors such as destabilization, low grade degeneration and an unfavorable biomechanical transition next to a rigid construct. An alternative surgical treatment is a hybrid construct, consisting of fusion and implantation of an interlaminar stabilization device at the adjacent level. The aim of this study was to compare long-term clinical outcome after lumbar fusion with a hybrid construct including an interlaminar stabilization device as "topping-off". A retrospective analysis of 25 lumbar spinal fusions from 2003 to 2010 with additional interlaminar stabilization device was performed. Through a matched case controlled procedure 25 congruent patients who received lumbar spinal fusion in one or two levels were included as a control group. At an average follow-up of 43 months pre- and postoperative pain, ODI, SF-36 as well as clinical parameters, such as leg and back pain, walking distance and patient satisfaction were recorded. Pain relief, ODI improvement and patient satisfaction was significantly higher in the hybrid group compared to the control group. SF-36 scores improved in both groups but was higher in the hybrid group, although without significance. Evaluation of walking distance showed no significant differences. Many outcome parameters present significantly better long-term results in the hybrid group compared to sole spinal fusion. Therefore, in cases with a clear indication for lumbar spinal fusion with the need for decompression at the adjacent level due to spinal stenosis or moderate spondylarthrosis, support of this segment with an interlaminar stabilization device demonstrates a reasonable treatment option with good clinical outcome. Also, the

A Summary of the NASA Fusion Propulsion Workshop 2000

NASA Technical Reports Server (NTRS)

Thio, Y. C. Francis; Turchi, Peter J.; Santarius, John F.; Schafer, Charles (Technical Monitor)

2001-01-01

A NASA Fusion Propulsion Workshop was held on Nov. 8 and 9, 2000 at Marshall Space Flight Center (MSFC) in Huntsville, Alabama. A total of 43 papers were presented at the Workshop orally or by posters, covering a broad spectrum of issues related to applying fusion to propulsion. The status of fusion research was reported at the Workshop showing the outstanding scientific research that has been accomplished worldwide in the fusion energy research program. The international fusion research community has demonstrated the scientific principles of fusion creating plasmas with conditions for fusion burn with a gain of order unity: 0.25 in Princeton TFTR, 0.65 in the Joint European Torus, and a Q-equivalent of 1.25 in Japan's JT-60. This research has developed an impressive range of physics and technological capabilities that may be applied effectively to the research of possibly new propulsion-oriented fusion schemes. The pertinent physics capabilities include the plasma computational tools, the experimental plasma facilities, the diagnostics techniques, and the theoretical understanding. The enabling technologies include the various plasma heating, acceleration, and the pulsed power technologies.

The effect of multispectral image fusion enhancement on human efficiency.

PubMed

Bittner, Jennifer L; Schill, M Trent; Mohd-Zaid, Fairul; Blaha, Leslie M

2017-01-01

The visual system can be highly influenced by changes to visual presentation. Thus, numerous techniques have been developed to augment imagery in an attempt to improve human perception. The current paper examines the potential impact of one such enhancement, multispectral image fusion, where imagery captured in varying spectral bands (e.g., visible, thermal, night vision) is algorithmically combined to produce an output to strengthen visual perception. We employ ideal observer analysis over a series of experimental conditions to (1) establish a framework for testing the impact of image fusion over the varying aspects surrounding its implementation (e.g., stimulus content, task) and (2) examine the effectiveness of fusion on human information processing efficiency in a basic application. We used a set of rotated Landolt C images captured with a number of individual sensor cameras and combined across seven traditional fusion algorithms (e.g., Laplacian pyramid, principal component analysis, averaging) in a 1-of-8 orientation task. We found that, contrary to the idea of fused imagery always producing a greater impact on perception, single-band imagery can be just as influential. Additionally, efficiency data were shown to fluctuate based on sensor combination instead of fusion algorithm, suggesting the need for examining multiple factors to determine the success of image fusion. Our use of ideal observer analysis, a popular technique from the vision sciences, provides not only a standard for testing fusion in direct relation to the visual system but also allows for comparable examination of fusion across its associated problem space of application.

Advances in multi-sensor data fusion: algorithms and applications.

PubMed

Dong, Jiang; Zhuang, Dafang; Huang, Yaohuan; Fu, Jingying

2009-01-01

With the development of satellite and remote sensing techniques, more and more image data from airborne/satellite sensors have become available. Multi-sensor image fusion seeks to combine information from different images to obtain more inferences than can be derived from a single sensor. In image-based application fields, image fusion has emerged as a promising research area since the end of the last century. The paper presents an overview of recent advances in multi-sensor satellite image fusion. Firstly, the most popular existing fusion algorithms are introduced, with emphasis on their recent improvements. Advances in main applications fields in remote sensing, including object identification, classification, change detection and maneuvering targets tracking, are described. Both advantages and limitations of those applications are then discussed. Recommendations are addressed, including: (1) Improvements of fusion algorithms; (2) Development of "algorithm fusion" methods; (3) Establishment of an automatic quality assessment scheme.

Enhancing hyperspectral spatial resolution using multispectral image fusion: A wavelet approach

NASA Astrophysics Data System (ADS)

Jazaeri, Amin

High spectral and spatial resolution images have a significant impact in remote sensing applications. Because both spatial and spectral resolutions of spaceborne sensors are fixed by design and it is not possible to further increase the spatial or spectral resolution, techniques such as image fusion must be applied to achieve such goals. This dissertation introduces the concept of wavelet fusion between hyperspectral and multispectral sensors in order to enhance the spectral and spatial resolution of a hyperspectral image. To test the robustness of this concept, images from Hyperion (hyperspectral sensor) and Advanced Land Imager (multispectral sensor) were first co-registered and then fused using different wavelet algorithms. A regression-based fusion algorithm was also implemented for comparison purposes. The results show that the fused images using a combined bi-linear wavelet-regression algorithm have less error than other methods when compared to the ground truth. In addition, a combined regression-wavelet algorithm shows more immunity to misalignment of the pixels due to the lack of proper registration. The quantitative measures of average mean square error show that the performance of wavelet-based methods degrades when the spatial resolution of hyperspectral images becomes eight times less than its corresponding multispectral image. Regardless of what method of fusion is utilized, the main challenge in image fusion is image registration, which is also a very time intensive process. Because the combined regression wavelet technique is computationally expensive, a hybrid technique based on regression and wavelet methods was also implemented to decrease computational overhead. However, the gain in faster computation was offset by the introduction of more error in the outcome. The secondary objective of this dissertation is to examine the feasibility and sensor requirements for image fusion for future NASA missions in order to be able to perform onboard image

FT-Raman and NIR spectroscopy data fusion strategy for multivariate qualitative analysis of food fraud.

PubMed

Márquez, Cristina; López, M Isabel; Ruisánchez, Itziar; Callao, M Pilar

2016-12-01

Two data fusion strategies (high- and mid-level) combined with a multivariate classification approach (Soft Independent Modelling of Class Analogy, SIMCA) have been applied to take advantage of the synergistic effect of the information obtained from two spectroscopic techniques: FT-Raman and NIR. Mid-level data fusion consists of merging some of the previous selected variables from the spectra obtained from each spectroscopic technique and then applying the classification technique. High-level data fusion combines the SIMCA classification results obtained individually from each spectroscopic technique. Of the possible ways to make the necessary combinations, we decided to use fuzzy aggregation connective operators. As a case study, we considered the possible adulteration of hazelnut paste with almond. Using the two-class SIMCA approach, class 1 consisted of unadulterated hazelnut samples and class 2 of samples adulterated with almond. Models performance was also studied with samples adulterated with chickpea. The results show that data fusion is an effective strategy since the performance parameters are better than the individual ones: sensitivity and specificity values between 75% and 100% for the individual techniques and between 96-100% and 88-100% for the mid- and high-level data fusion strategies, respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

Desensitized Optimal Filtering and Sensor Fusion Toolkit

NASA Technical Reports Server (NTRS)

Karlgaard, Christopher D.

2015-01-01

Analytical Mechanics Associates, Inc., has developed a software toolkit that filters and processes navigational data from multiple sensor sources. A key component of the toolkit is a trajectory optimization technique that reduces the sensitivity of Kalman filters with respect to model parameter uncertainties. The sensor fusion toolkit also integrates recent advances in adaptive Kalman and sigma-point filters for non-Gaussian problems with error statistics. This Phase II effort provides new filtering and sensor fusion techniques in a convenient package that can be used as a stand-alone application for ground support and/or onboard use. Its modular architecture enables ready integration with existing tools. A suite of sensor models and noise distribution as well as Monte Carlo analysis capability are included to enable statistical performance evaluations.

Fusion and quality analysis for remote sensing images using contourlet transform

NASA Astrophysics Data System (ADS)

Choi, Yoonsuk; Sharifahmadian, Ershad; Latifi, Shahram

2013-05-01

Recent developments in remote sensing technologies have provided various images with high spatial and spectral resolutions. However, multispectral images have low spatial resolution and panchromatic images have low spectral resolution. Therefore, image fusion techniques are necessary to improve the spatial resolution of spectral images by injecting spatial details of high-resolution panchromatic images. The objective of image fusion is to provide useful information by improving the spatial resolution and the spectral information of the original images. The fusion results can be utilized in various applications, such as military, medical imaging, and remote sensing. This paper addresses two issues in image fusion: i) image fusion method and ii) quality analysis of fusion results. First, a new contourlet-based image fusion method is presented, which is an improvement over the wavelet-based fusion. This fusion method is then applied to a case study to demonstrate its fusion performance. Fusion framework and scheme used in the study are discussed in detail. Second, quality analysis for the fusion results is discussed. We employed various quality metrics in order to analyze the fusion results both spatially and spectrally. Our results indicate that the proposed contourlet-based fusion method performs better than the conventional wavelet-based fusion methods.

Fusion 2.0: The Next Generation of Fusion in California: Aligning State and Regional Fusion Centers

DTIC Science & Technology

2010-03-01

bible ” for fusion center management, as evidenced by the theme of the 2009 National Fusion Center Conference; appropriately called “Achieving Baseline...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS FUSION 2.0: THE NEXT GENERATION OF FUSION IN CALIFORNIA: ALIGNING STATE AND...Master’s Thesis 4. TITLE AND SUBTITLE Fusion 2.0: The Next Generation of Fusion in California: Aligning State and Regional Fusion

Multi-scale pixel-based image fusion using multivariate empirical mode decomposition.

PubMed

Rehman, Naveed ur; Ehsan, Shoaib; Abdullah, Syed Muhammad Umer; Akhtar, Muhammad Jehanzaib; Mandic, Danilo P; McDonald-Maier, Klaus D

2015-05-08

A novel scheme to perform the fusion of multiple images using the multivariate empirical mode decomposition (MEMD) algorithm is proposed. Standard multi-scale fusion techniques make a priori assumptions regarding input data, whereas standard univariate empirical mode decomposition (EMD)-based fusion techniques suffer from inherent mode mixing and mode misalignment issues, characterized respectively by either a single intrinsic mode function (IMF) containing multiple scales or the same indexed IMFs corresponding to multiple input images carrying different frequency information. We show that MEMD overcomes these problems by being fully data adaptive and by aligning common frequency scales from multiple channels, thus enabling their comparison at a pixel level and subsequent fusion at multiple data scales. We then demonstrate the potential of the proposed scheme on a large dataset of real-world multi-exposure and multi-focus images and compare the results against those obtained from standard fusion algorithms, including the principal component analysis (PCA), discrete wavelet transform (DWT) and non-subsampled contourlet transform (NCT). A variety of image fusion quality measures are employed for the objective evaluation of the proposed method. We also report the results of a hypothesis testing approach on our large image dataset to identify statistically-significant performance differences.

Multi-Scale Pixel-Based Image Fusion Using Multivariate Empirical Mode Decomposition

PubMed Central

Rehman, Naveed ur; Ehsan, Shoaib; Abdullah, Syed Muhammad Umer; Akhtar, Muhammad Jehanzaib; Mandic, Danilo P.; McDonald-Maier, Klaus D.

2015-01-01

A novel scheme to perform the fusion of multiple images using the multivariate empirical mode decomposition (MEMD) algorithm is proposed. Standard multi-scale fusion techniques make a priori assumptions regarding input data, whereas standard univariate empirical mode decomposition (EMD)-based fusion techniques suffer from inherent mode mixing and mode misalignment issues, characterized respectively by either a single intrinsic mode function (IMF) containing multiple scales or the same indexed IMFs corresponding to multiple input images carrying different frequency information. We show that MEMD overcomes these problems by being fully data adaptive and by aligning common frequency scales from multiple channels, thus enabling their comparison at a pixel level and subsequent fusion at multiple data scales. We then demonstrate the potential of the proposed scheme on a large dataset of real-world multi-exposure and multi-focus images and compare the results against those obtained from standard fusion algorithms, including the principal component analysis (PCA), discrete wavelet transform (DWT) and non-subsampled contourlet transform (NCT). A variety of image fusion quality measures are employed for the objective evaluation of the proposed method. We also report the results of a hypothesis testing approach on our large image dataset to identify statistically-significant performance differences. PMID:26007714

Case presentation and short perspective on management of foraminal/far lateral discs and stenosis.

PubMed

Epstein, Nancy E

2018-01-01

The management of lumbar foraminal/far lateral discs (FOR/FLD) with stenosis remains controversial. Operative choices should be based on each patient's preoperative dynamic X-ray findings, magnetic resonance (MR), and computed tomography (CT) studies. Here we reviewed several options for decompression alone vs. decompression with fusion. Safe excision of FOR/FLD with stenosis should begin at the level above the disc herniation, as identification of the superior, foraminally, and far laterally exiting nerve root is critical. Performing an undercutting laminectomy and utilizing an operating microscope usually preserves the facet joints, and in many cases, avoids the need for fusion. Other decompressive techniques include; the intertransverse (ITT), and Wiltse approaches. Fusions following complete unilateral full facetectomy may be; noninstrumented (e.g., older, osteoporotic patients) vs. instrumented (e.g., posterolateral fusion or occasionally transforaminal lumbar interbody fusion). Here we present a patient with L2-L5 stenosis, and a left L3-L4 FOR/FLD, and multiple synovial cysts who was successfully managed with an l2-L5 laminecotmy, left L34 FOR/FLD diksectomy without fusion. Postoperatively, the patient was neurologically intact, and stability was maintained. Adjunctive measures for FOR/FLD diksectomy should include; intraoperative monitoring, use of the operating microscope, and an intraoperative film with a radiopaque marker in the correct disc space to confirm the correct level of diskectomy. There are multiple approaches to the excision of FOR/FLD with stenosis. These include; decompression alone vs. decompression with non-instrumented vs. instrumented fusion. Surgical choices must be based on individual patient's X-ray, MR, and CT findings. The aim should be to maximize the safety of disc excision with decompression of stenosis, and to preserve stability, reducing the need for fusion, while minimizing morbidity.

The da Vinci robotic surgical assisted anterior lumbar interbody fusion: technical development and case report.

PubMed

Beutler, William J; Peppelman, Walter C; DiMarco, Luciano A

2013-02-15

Technique development to use the da Vince Robotic Surgical System for anterior lumbar interbody fusion at L5-S1 is detailed. A case report is also presented. To evaluate and develop the da Vinci robotic assisted laparoscopic anterior lumbar stand-alone interbody fusion procedure. Anterior lumbar interbody fusion is a common procedure associated with potential morbidity related to the surgical approach. The da Vinci robot provides intra-abdominal dissection and visualization advantages compared with the traditional open and laparoscopic approach. The surgical techniques for approach to the anterior lumbar spine using the da Vinci robot were developed and modified progressively beginning with operative models followed by placement of an interbody fusion cage in the living porcine model. Development continued to progress with placement of fusion cage in a human cadaver, completed first in the laboratory setting and then in the operating room. Finally, the first patient with fusion completed using the da Vinci robot-assisted approach is presented. The anterior transperitoneal approach to the lumbar spine is accomplished with enhanced visualization and dissection capability, with maintenance of pneumoperitoneum using the da Vinci robot. Blood loss is minimal. The visualization inside the disc space and surrounding structures was considered better than current open and laparoscopic techniques. The da Vinci robot Surgical System technique continues to develop and is now described for the transperitoneal approach to the anterior lumbar spine. 4.

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

PubMed

Heiney, Jake; Capobianco, Robyn; Cher, Daniel

2015-01-01

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. 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. 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. Published studies of MIS SI joint fusion using a lateral transarticular approach confirm its minimally invasive characteristics with

Fusion and Gaussian mixture based classifiers for SONAR data

NASA Astrophysics Data System (ADS)

Kotari, Vikas; Chang, KC

2011-06-01

Underwater mines are inexpensive and highly effective weapons. They are difficult to detect and classify. Hence detection and classification of underwater mines is essential for the safety of naval vessels. This necessitates a formulation of highly efficient classifiers and detection techniques. Current techniques primarily focus on signals from one source. Data fusion is known to increase the accuracy of detection and classification. In this paper, we formulated a fusion-based classifier and a Gaussian mixture model (GMM) based classifier for classification of underwater mines. The emphasis has been on sound navigation and ranging (SONAR) signals due to their extensive use in current naval operations. The classifiers have been tested on real SONAR data obtained from University of California Irvine (UCI) repository. The performance of both GMM based classifier and fusion based classifier clearly demonstrate their superior classification accuracy over conventional single source cases and validate our approach.

Fusion plasma theory project summaries

NASA Astrophysics Data System (ADS)

1993-10-01

This Project Summary book is a published compilation consisting of short descriptions of each project supported by the Fusion Plasma Theory and Computing Group of the Advanced Physics and Technology Division of the Department of Energy, Office of Fusion Energy. The summaries contained in this volume were written by the individual contractors with minimal editing by the Office of Fusion Energy. Previous summaries were published in February of 1982 and December of 1987. The Plasma Theory program is responsible for the development of concepts and models that describe and predict the behavior of a magnetically confined plasma. Emphasis is given to the modelling and understanding of the processes controlling transport of energy and particles in a toroidal plasma and supporting the design of the International Thermonuclear Experimental Reactor (ITER). A tokamak transport initiative was begun in 1989 to improve understanding of how energy and particles are lost from the plasma by mechanisms that transport them across field lines. The Plasma Theory program has actively participated in this initiative. Recently, increased attention has been given to issues of importance to the proposed Tokamak Physics Experiment (TPX). Particular attention has been paid to containment and thermalization of fast alpha particles produced in a burning fusion plasma as well as control of sawteeth, current drive, impurity control, and design of improved auxiliary heating. In addition, general models of plasma behavior are developed from physics features common to different confinement geometries. This work uses both analytical and numerical techniques. The Fusion Theory program supports research projects at U.S. government laboratories, universities and industrial contractors. Its support of theoretical work at universities contributes to the office of Fusion Energy mission of training scientific manpower for the U.S. Fusion Energy Program.

Application of Advanced Nuclear Emulsion Technique to Fusion Neutron Diagnostics

NASA Astrophysics Data System (ADS)

Nakayama, Y.; Tomita, H.; Morishima, K.; Yamashita, F.; Hayashi, S.; Cheon, MunSeong; Isobe, M.; Ogawa, K.; Naka, T.; Nakano, T.; Nakamura, M.; Kawarabayashi, J.; Iguchi, T.; Ochiai, K.

In order to measure the 2.5 MeV neutrons produced by DD nuclear fusion reactions, we have developed a compact neutron detector based on nuclear emulsion. After optimization of development conditions, we evaluated the response of the detector to an accelerator-based DD neutron source. The absolute efficiency at an energy of 2.5 MeV was estimated to be (4.1±0.2)×10-6 tracks/neutron.

[Mechanical studies of lumbar interbody fusion implants].

PubMed

Bader, R J; Steinhauser, E; Rechl, H; Mittelmeier, W; Bertagnoli, R; Gradinger, R

2002-05-01

In addition to autogenous or allogeneic bone grafts, fusion cages composed of metal or plastic are being used increasingly as spacers for interbody fusion of spinal segments. The goal of this study was the mechanical testing of carbon fiber reinforced plastic (CFRP) fusion cages used for anterior lumbar interbody fusion. With a special testing device according to American Society for Testing and Materials (ASTM) standards, the mechanical properties of the implants were determined under four different loading conditions. The implants (UNION cages, Medtronic Sofamor Danek) provide sufficient axial compression, shear, and torsional strength of the implant body. Ultimate axial compression load of the fins is less than the physiological compression loads at the lumbar spine. Therefore by means of an appropriate surgical technique parallel grooves have to be reamed into the endplates of the vertebral bodies according to the fin geometry. Thereby axial compression forces affect the implants body and the fins are protected from damaging loading. Using a supplementary anterior or posterior instrumentation, in vivo failure of the fins as a result of physiological shear and torsional spinal loads is unlikely. Due to specific complications related to autogenous or allogeneic bone grafts, fusion cages made of metal or carbon fiber reinforced plastic are an important alternative implant in interbody fusion.

The emissivities of liquid metals at their fusion temperatures.

NASA Technical Reports Server (NTRS)

Bonnell, D. W.; Treverton, J. A.; Valerga, A. J.; Margrave , J. L.

1972-01-01

The emissivities for several transition metals and various other metals and compounds in the liquid state at their fusion temperatures have been determined in this laboratory. The technique used involves electromagnetic levitation-induction heating of the materials in an inert atmosphere. The brightness temperature of the liquid phase of the material is measured as the material is heated through fusion. Given a reliable value of the fusion temperature, which is available for most pure substances, one may readily calculate an emissivity for the liquid phase at the fusion temperature. Even in cases where melting points are poorly known, the brightness temperatures are unique parameters, independent of the temperature scale and measured for a chemically defined system at a fixed point.

Transforaminal epidural steroid injections influence Mechanical Diagnosis and Therapy (MDT) pain response classification in candidates for lumbar herniated disc surgery.

PubMed

van Helvoirt, Hans; Apeldoorn, Adri T; Knol, Dirk L; Arts, Mark P; Kamper, Steven J; van Tulder, Maurits W; Ostelo, Raymond W

2016-04-27

Prospective cohort study. Although lumbar radiculopathy is regarded as a specific diagnosis, the most effective treatment strategy is unclear. Commonly used treatments include transforaminal epidural steroid injections (TESIs) and Mechanical Diagnosis & Therapy (MDT), but no studies have investigated the effectiveness of this combination. MDT differentiates pain centralization (C) from non-centralization (NC), which indicates good vs. poor prognostic validity respectively. The main aims were 1) to determine changes in Mechanical Diagnosis and Therapy (MDT) pain response classifications after transforaminal epidural steroid injections (TESIs) in candidates for lumbar herniated disc surgery and 2) to evaluate differences in short and long term outcomes for patients with different pain response classifications. Candidates for lumbar herniated disc surgery were assessed with a MDT protocol and their pain response classified as centralizing or peripheralizing. For this study,only patients were eligible who showed a peripheralizing pain response at intake. All patients then received TESIs and were reassessed and classified using the MDT protocol, into groups according to pain response (resolved, centralizing, peripheralizing with less pain and peripheralising with severe pain). After receiving targeted treatment based on pain response after TESIs, ranging from advice, MDT or surgery, follow-up assessments were completed at discharge and at 12 months. The primary outcomes were disability (Roland-Morris Disability Questionnaire [RMDQ] for Sciatica), pain severity in leg (visual analogue scale [VAS], 0-100) and global perceived effect (GPE). Linear mixed-models were used to determine between-groups differences in outcome. A total of 77 patients with lumbar disc herniation and peripheralizing symptoms were included. Patients received an average of 2 (SD 0.7) TESIs. After TESIs, 17 patients (22%) were classified as peripheralizing with continuing severe pain.These patients

Sacroiliac Joint Fusion: One Year Clinical and Radiographic Results Following Minimally Invasive Sacroiliac Joint Fusion Surgery

PubMed Central

Kube, Richard A.; Muir, Jeffrey M.

2016-01-01

Background: Recalcitrant sacroiliac joint pain responds well to minimally-invasive surgical (MIS) techniques, although long-term radiographic and fusion data are limited. Objective: To evaluate the one-year clinical results from a cohort of patients with chronic sacroiliac (SI) joint pain unresponsive to conservative therapies who have undergone minimally invasive SI joint fusion. Methods: SI joint fusion was performed between May 2011 and January 2014. Outcomes included radiographic assessment of fusion status, leg and back pain severity via visual analog scale (VAS), disability via Oswestry Disability Index (ODI) and complication rate. Outcomes were measured at baseline and at follow-up appointments 6 months and 12 months post-procedure. Results: Twenty minimally invasive SI joint fusion procedures were performed on 18 patients (mean age: 47.2 (14.2), mean BMI: 29.4 (5.3), 56% female). At 12 months, the overall fusion rate was 88%. Back and leg pain improved from 81.7 to 44.1 points (p<0.001) and from 63.6 to 27.7 points (p=0.001), respectively. Disability scores improved from 61.0 to 40.5 (p=0.009). Despite a cohort containing patients with multiple comorbidities and work-related injuries, eight patients (50%) achieved the minimal clinically important difference (MCID) in back pain at 12 months, with 9 (69%) patients realizing this improvement in leg pain and 8 (57%) realizing the MCID in ODI scores at 12 months. No major complications were reported. Conclusion: Minimally invasive SI joint surgery is a safe and effective procedure, with a high fusion rate, a satisfactory safety profile and significant improvements in pain severity and disability reported through 12 months post-procedure. PMID:28144378

Sacroiliac Joint Fusion: One Year Clinical and Radiographic Results Following Minimally Invasive Sacroiliac Joint Fusion Surgery.

PubMed

Kube, Richard A; Muir, Jeffrey M

2016-01-01

Recalcitrant sacroiliac joint pain responds well to minimally-invasive surgical (MIS) techniques, although long-term radiographic and fusion data are limited. To evaluate the one-year clinical results from a cohort of patients with chronic sacroiliac (SI) joint pain unresponsive to conservative therapies who have undergone minimally invasive SI joint fusion. SI joint fusion was performed between May 2011 and January 2014. Outcomes included radiographic assessment of fusion status, leg and back pain severity via visual analog scale (VAS), disability via Oswestry Disability Index (ODI) and complication rate. Outcomes were measured at baseline and at follow-up appointments 6 months and 12 months post-procedure. Twenty minimally invasive SI joint fusion procedures were performed on 18 patients (mean age: 47.2 (14.2), mean BMI: 29.4 (5.3), 56% female). At 12 months, the overall fusion rate was 88%. Back and leg pain improved from 81.7 to 44.1 points (p<0.001) and from 63.6 to 27.7 points (p=0.001), respectively. Disability scores improved from 61.0 to 40.5 (p=0.009). Despite a cohort containing patients with multiple comorbidities and work-related injuries, eight patients (50%) achieved the minimal clinically important difference (MCID) in back pain at 12 months, with 9 (69%) patients realizing this improvement in leg pain and 8 (57%) realizing the MCID in ODI scores at 12 months. No major complications were reported. Minimally invasive SI joint surgery is a safe and effective procedure, with a high fusion rate, a satisfactory safety profile and significant improvements in pain severity and disability reported through 12 months post-procedure.

The exocytotic fusion pore modeled as a lipidic pore.

PubMed Central

Nanavati, C; Markin, V S; Oberhauser, A F; Fernandez, J M

1992-01-01

Freeze-fracture electron micrographs from degranulating cells show that the lumen of the secretory granule is connected to the extracellular compartment via large (20 to 150 nm diameter) aqueous pores. These exocytotic fusion pores appear to be made up of a highly curved bilayer that spans the plasma and granule membranes. Conductance measurements, using the patch-clamp technique, have been used to study the fusion pore from the instant it conducts ions. These measurements reveal the presence of early fusion pores that are much smaller than those observed in electron micrographs. Early fusion pores open abruptly, fluctuate, and then either expand irreversibly or close. The molecular structure of these early fusion pores is unknown. In the simplest extremes, these early fusion pores could be either ion channel like protein pores or lipidic pores. Here, we explored the latter possibility, namely that of the early exocytotic fusion pore modeled as a lipid-lined pore whose free energy was composed of curvature elastic energy and work done by tension. Like early exocytotic fusion pores, we found that these lipidic pores could open abruptly, fluctuate, and expand irreversibly. Closure of these lipidic pores could be caused by slight changes in lipid composition. Conductance distributions for stable lipidic pores matched those of exocytotic fusion pores. These findings demonstrate that lipidic pores can exhibit the properties of exocytotic fusion pores, thus providing an alternate framework with which to understand and interpret exocytotic fusion pore data. PMID:1420930

Tools and Methods for the Registration and Fusion of Remotely Sensed Data

NASA Technical Reports Server (NTRS)

Goshtasby, Arthur Ardeshir; LeMoigne, Jacqueline

2010-01-01

Tools and methods for image registration were reviewed. Methods for the registration of remotely sensed data at NASA were discussed. Image fusion techniques were reviewed. Challenges in registration of remotely sensed data were discussed. Examples of image registration and image fusion were given.

Occipitocervical fusion using a contoured rod and wire construct in children: a reappraisal of a vintage technique.

PubMed

Klimo, Paul; Astur, Nelson; Gabrick, Kyle; Warner, William C; Muhlbauer, Michael S

2013-02-01

Many methods to stabilize and fuse the craniocervical junction have been described. One of the early designs was a contoured (Luque) rod fixated with wires, the so-called Hartshill-Ransford loop. In this study, the authors report their 20-year experience with this surgical technique in children. The authors reviewed the medical records of patients 18 years of age or younger who underwent dorsal occipitocervical fusion procedures between March 1992 and March 2012 at Le Bonheur Children's Hospital using a contoured rod and wire construct. Data on basic patient characteristics, causes of instability, neurological function at presentation and at last follow-up, details of surgery, complications, and radiographic outcome were collected. Twenty patients (11 male) were identified, with a mean age of 5.5 years (range 1-18 years) and a median follow-up of 43.5 months. Fourteen patients had atlantooccipital dislocation, 2 patients had atlantoaxial fracture-dissociations, 2 had Down syndrome with occipitocervical and atlantoaxial instability, 1 had an epithelioid sarcoma from the clivus to C-2, and 1 had an anomalous atlas with resultant occipitocervical instability. Surgical stabilization extended from the occiput to C-1 in 3 patients, C-2 in 6, C-3 in 8, and to C-4 in 3. Bone morphogenetic protein was used in 2 patients. Two patients were placed in a halo orthosis; the rest were kept in a hard collar for 6-8 weeks. All patients were neurologically stable after surgery. One patient with a dural tear experienced wound dehiscence with CSF leakage and required reoperation. Eighteen patients went on to achieve fusion within 6 months of surgery; 1 patient was initially lost to follow-up, but recent imaging demonstrated a solid fusion. There were no early hardware or bone failures requiring hardware removal, but radiographs obtained 8 years after surgery showed that 1 patient had an asymptomatic fractured rod. There were no instances of symptomatic junctional degeneration, and no

Multiscale image fusion using the undecimated wavelet transform with spectral factorization and nonorthogonal filter banks.

PubMed

Ellmauthaler, Andreas; Pagliari, Carla L; da Silva, Eduardo A B

2013-03-01

Multiscale transforms are among the most popular techniques in the field of pixel-level image fusion. However, the fusion performance of these methods often deteriorates for images derived from different sensor modalities. In this paper, we demonstrate that for such images, results can be improved using a novel undecimated wavelet transform (UWT)-based fusion scheme, which splits the image decomposition process into two successive filtering operations using spectral factorization of the analysis filters. The actual fusion takes place after convolution with the first filter pair. Its significantly smaller support size leads to the minimization of the unwanted spreading of coefficient values around overlapping image singularities. This usually complicates the feature selection process and may lead to the introduction of reconstruction errors in the fused image. Moreover, we will show that the nonsubsampled nature of the UWT allows the design of nonorthogonal filter banks, which are more robust to artifacts introduced during fusion, additionally improving the obtained results. The combination of these techniques leads to a fusion framework, which provides clear advantages over traditional multiscale fusion approaches, independent of the underlying fusion rule, and reduces unwanted side effects such as ringing artifacts in the fused reconstruction.

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

Sampling the kinetic pathways of a micelle fusion and fission transition.

PubMed

Pool, René; Bolhuis, Peter G

2007-06-28

The mechanism and kinetics of micellar breakup and fusion in a dilute solution of a model surfactant are investigated by path sampling techniques. Analysis of the path ensemble gives insight in the mechanism of the transition. For larger, less stable micelles the fission/fusion occurs via a clear neck formation, while for smaller micelles the mechanism is more direct. In addition, path analysis yields an appropriate order parameter to evaluate the fusion and fission rate constants using stochastic transition interface sampling. For the small, stable micelle (50 surfactants) the computed fission rate constant is a factor of 10 lower than the fusion rate constant. The procedure opens the way for accurate calculation of free energy and kinetics for, e.g., membrane fusion, and wormlike micelle endcap formation.

[Contrast-enhanced ultrasound (CEUS) and image fusion for procedures of liver interventions].

PubMed

Jung, E M; Clevert, D A

2018-06-01

Contrast-enhanced ultrasound (CEUS) is becoming increasingly important for the detection and characterization of malignant liver lesions and allows percutaneous treatment when surgery is not possible. Contrast-enhanced ultrasound image fusion with computed tomography (CT) and magnetic resonance imaging (MRI) opens up further options for the targeted investigation of a modified tumor treatment. Ultrasound image fusion offers the potential for real-time imaging and can be combined with other cross-sectional imaging techniques as well as CEUS. With the implementation of ultrasound contrast agents and image fusion, ultrasound has been improved in the detection and characterization of liver lesions in comparison to other cross-sectional imaging techniques. In addition, this method can also be used for intervention procedures. The success rate of fusion-guided biopsies or CEUS-guided tumor ablation lies between 80 and 100% in the literature. Ultrasound-guided image fusion using CT or MRI data, in combination with CEUS, can facilitate diagnosis and therapy follow-up after liver interventions. In addition to the primary applications of image fusion in the diagnosis and treatment of liver lesions, further useful indications can be integrated into daily work. These include, for example, intraoperative and vascular applications as well applications in other organ systems.

"Push-Through" Rod Passage Technique for the Improvement of Lumbar Lordosis and Sagittal Balance in Minimally Invasive Adult Degenerative Scoliosis Surgery.

PubMed

Haque, Raqeeb M; Uddin, Omar M; Ahmed, Yousef; El Ahmadieh, Tarek Y; Hashmi, Sohaib Z; Shah, Amir; Fessler, Richard G

2016-10-01

Traditional open surgical techniques for correction of adult degenerative scoliosis (ADS) are often associated with increased blood loss, postoperative pain, and complications. Minimally invasive (MIS) techniques have been utilized to address these issues; however, concerns regarding improving certain alignment parameters have been raised. A new "push-through" technique for MIS correction of ADS has been developed wherein a rod is bent before its placement into the screw heads and then contoured further to yield improved correction of radiographic parameters. Preoperative and postoperative radiographic measurements of 3 patients who underwent MIS correction of scoliosis using the "push-through" technique were compared with 22 prior patients who had received traditional MIS correction. All patients received staged correction of scoliosis. The first stage involved insertion of lateral lumbar interbodies. Standing x-rays were then evaluated for overall global balance. The second stage involved appropriate MIS facetectomies, facet fusions, posterior transforaminal interbodies at lower lumbar segments, and finally the placement of rods.TECHNIQUE OVERVIEW:: (1) A long rod composed of titanium is bent with a mild lordosis and passed through the extensions of the screw heads cephalad to caudad. (2) The rod is passed fully through the incision so it extrudes from the caudal end of the construct. At this point, further lordosis is bent into the rods. (3) The rod is then pulled back into the appropriate position. (4) The unnecessary cephalad rod is then cut to appropriate length with a circular saw. (5) Rod reducers are then sequentially lowered and tightened to achieve the desired correction. Mean age for all patients was 66.02 years. Preoperative coronal Cobb, sagittal vertical axis (SVA), and pelvic incidence (PI) were similar in all patients, whereas lumbar lordosis (LL) was smaller (15.27 vs. 29.85 degrees, P=0.00389) and pelvic tilt (PT) was larger (37.00 vs. 27

EDITORIAL: The Nuclear Fusion Award The Nuclear Fusion Award

NASA Astrophysics Data System (ADS)

Kikuchi, M.

2011-01-01

The Nuclear Fusion Award ceremony for 2009 and 2010 award winners was held during the 23rd IAEA Fusion Energy Conference in Daejeon. This time, both 2009 and 2010 award winners were celebrated by the IAEA and the participants of the 23rd IAEA Fusion Energy Conference. The Nuclear Fusion Award is a paper prize to acknowledge the best distinguished paper among the published papers in a particular volume of the Nuclear Fusion journal. Among the top-cited and highly-recommended papers chosen by the Editorial Board, excluding overview and review papers, and by analyzing self-citation and non-self-citation with an emphasis on non-self-citation, the Editorial Board confidentially selects ten distinguished papers as nominees for the Nuclear Fusion Award. Certificates are given to the leading authors of the Nuclear Fusion Award nominees. The final winner is selected among the ten nominees by the Nuclear Fusion Editorial Board voting confidentially. 2009 Nuclear Fusion Award nominees For the 2009 award, the papers published in the 2006 volume were assessed and the following papers were nominated, most of which are magnetic confinement experiments, theory and modeling, while one addresses inertial confinement. Sabbagh S.A. et al 2006 Resistive wall stabilized operation in rotating high beta NSTX plasmas Nucl. Fusion 46 635-44 La Haye R.J. et al 2006 Cross-machine benchmarking for ITER of neoclassical tearing mode stabilization by electron cyclotron current drive Nucl. Fusion 46 451-61 Honrubia J.J. et al 2006 Three-dimensional fast electron transport for ignition-scale inertial fusion capsules Nucl. Fusion 46 L25-8 Ido T. et al 2006 Observation of the interaction between the geodesic acoustic mode and ambient fluctuation in the JFT-2M tokamak Nucl. Fusion 46 512-20 Plyusnin V.V. et al 2006 Study of runaway electron generation during major disruptions in JET Nucl. Fusion 46 277-84 Pitts R.A. et al 2006 Far SOL ELM ion energies in JET Nucl. Fusion 46 82-98 Berk H.L. et al 2006

Methods of detection using a cellulose binding domain fusion product

DOEpatents

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

1999-01-05

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. 34 figs.

Methods of detection using a cellulose binding domain fusion product

DOEpatents

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

1999-01-01

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.

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.

Failure analysis of knee arthrodesis with the WichitaFusion Nail.

PubMed

Parcel, Ted W; Levering, Melissa; Polikandriotis, John A; Gustke, Kenneth A; Bernasek, Thomas L

2013-11-01

Arthrodesis is a salvage procedure for failed total knee arthroplasty with the intent to create a stable, pain-free limb on which to ambulate or transfer. For many patients, the alternative to arthrodesis may be an above-knee amputation. Available techniques for knee arthrodesis include compression plating, external fixators, and intramedullary fixation. The purpose of this study was to report the knee fusion rate of consecutive patients at 1 institution using an intramedullary fusion nail and to identify patient risk factors for fusion failure. Between November 1998 and November 2008, twenty-eight patients undergoing knee arthrodesis with an average follow-up of 18 months (range, 3-64 months) were retrospectively studied. Demographic information, presence of fusion, clinical function, pain level, and bone defect data were collected and analyzed. Eighty-two percent (23/28) of patients had radiographic evidence of successful fusion with an average time to fusion of 21 weeks (range, 10-58 weeks). When examining patient variables that could correlate with fusion rates, patients with an Anderson Orthopaedic Research Institute type 3 femoral or type 3 tibial defect had a statistically significant lower fusion rate. The intramedullary fusion nail is an effective device for knee arthrodesis that offers ease of insertion through the knee wound with the advantages of initial bone compression and rigid fixation. Although the use of intramedullary fusion nails leads to a high fusion rate, significant bone deficiency limits successful fusion. Copyright 2013, SLACK Incorporated.

Magnetized Target Fusion in Advanced Propulsion Research

NASA Technical Reports Server (NTRS)

Cylar, Rashad

2003-01-01

The Magnetized Target Fusion (MTF) Propulsion lab at NASA Marshall Space Flight Center in Huntsville, Alabama has a program in place that has adopted to attempt to create a faster, lower cost and more reliable deep space transportation system. In this deep space travel the physics and development of high velocity plasma jets must be understood. The MTF Propulsion lab is also in attempt to open up the solar system for human exploration and commercial use. Fusion, as compared to fission, is just the opposite. Fusion involves the light atomic nuclei combination to produce denser nuclei. In the process, the energy is created by destroying the mass according to the distinguished equation: E = mc2 . Fusion energy development is being pursued worldwide as a very sustainable form of energy that is environmentally friendly. For the purposes of space exploration fusion reactions considered include the isotopes of hydrogen-deuterium (D2) and tritium (T3). Nuclei have an electrostatic repulsion between them and in order for the nuclei to fuse this repulsion must be overcome. One technique to bypass repulsion is to heat the nuclei to very high temperatures. The temperatures vary according to the type of reactions. For D-D reactions, one billion degrees Celsius is required, and for D-T reactions, one hundred million degrees is sufficient. There has to be energy input for useful output to be obtained form the fusion To make fusion propulsion practical, the mass, the volume, and the cost of the equipment to produce the reactions (generally called the reactor) need to be reduced by an order of magnitude or two from the state-of-the-art fusion machines. Innovations in fusion schemes are therefore required, especially for obtaining thrust for propulsive applications. Magnetized target fusion (MTF) is one of the innovative fusion concepts that have emerged over the last several years. MSFC is working with Los Alamos National Laboratory and other research groups in studying the

Hybrid circumferential fixation for degenerative lumbosacral spine disease: posterior lumbar interbody fusion plus universal clamp rod-band instrumentation: a novel technique for lumbosacral fixation.

PubMed

Tegos, Stergios; Charitidis, Charalampos; Korovessis, Panagiotis G

2014-04-01

spinal surgery until the final evaluation. UC, a novel semirigid sublaminar posterior instrumentation, combined with wedge-shaped PEEK PLIF corrected both global and segmental sagittal lumbar alignment and achieved fusion rate similar to that historically reported with pedicle screw-PLIF techniques, however, avoiding intraoperative complications associated with the use of pedicle screws.

Efficacy of Zero-Profile Implant in Anterior Fusion to Treat Degenerative Cervical Spine Disease: Comparison with Techniques Using Bone Graft and Anterior Plating.

PubMed

Chang, Han; Baek, Dong-Hoon; Choi, Byung-Wan

2015-07-01

The efficacy of anterior fusion using zero-profile implant (Zero-P) in the surgical treatment of degenerative cervical disease was investigated through radiographic and clinical comparisons with existing treatments using autograft or allograft and anterior plating. A total of 130 patients who underwent anterior decompression and fusion for degenerative cervical spine disease with a follow-up of at least 1 year were analyzed retrospectively. The cases were divided into three groups: autograft and plate (38 cases, group A), allograft and plate (44 cases, group B), and Zero-P (48 cases, group C). Maintenance of lordosis, extent of subsidence, and fusion were evaluated radiologically and compared among preoperative, postoperative, and final follow-up time points. In addition, changes in Visual Analog Scale (VAS) and Neurologic Disability Index (NDI) scores and the presence of complications were evaluated for clinical analysis. Operation time was significantly less in group C (p = 0.007, 0.002). Maintenance of entire and segmental lordosis after surgery was better in groups A and B compared with group C (p = 0.002, 0.001); however, the extent of loss of lordosis from the surgery to the final follow-up did not show any significant differences. Regarding the extent of subsidence, the increase of height between the vertebral bodies after the surgery was 3.10, 2.89, and 2.68 mm in group A, group B, and group C, respectively (p = 0.14), and changed to - 1.27, - 2.41, and - 1.2 mm at the final follow-up (p = 0.012). VAS and NDI scores were improved from 7.2 to 3 and 34 to 12, respectively, but there were no significant differences. Nonunion occurred in two cases in both group B and group C. In terms of clinical complications, two cases of persistent donor site pain were found in group A; one case of persistent dysphagia was found in both group A and group B. Anterior cervical fusion using Zero-P has a shorter operation time and less

Flexible single-incision surgery: a fusion technique.

PubMed

Noguera, José F; Dolz, Carlos; Cuadrado, Angel; Olea, José; García, Juan

2013-06-01

The development of natural orifice transluminal endoscopic surgery has led to other techniques, such as single-incision surgery. The use of the flexible endoscope for single-incision surgery paves the way for further refinement of both surgical methods. To describe a new, single-incision surgical technique, namely, flexible single-incision surgery. Assessment of the safety and effectiveness of endoscopic cholecystectomy in a series of 30 patients. This technique consists of a single umbilical incision through which a flexible endoscope is introduced and consists of 2 parallel entry ports that provide access to nonarticulated laparoscopic instruments. The technique was applied in all patients for whom it was prescribed. No general or surgical wound complications were noted. Surgical time was no longer than usual for single-port surgery. Flexible single-incision surgery is a new single-site surgical technique offering the same level of patient safety, with additional advantages for the surgeon at minimal cost.

Direct current stimulation of titanium interbody fusion devices in primates.

PubMed

Cook, Stephen D; Patron, Laura P; Christakis, Petros M; Bailey, Kirk J; Banta, Charles; Glazer, Paul A

2004-01-01

The fusion rate for anterior lumbar interbody fusion (ALIF) varies widely with the use of different interbody devices and bone graft options. Adjunctive techniques such as electrical stimulation may improve the rate of bony fusion. To determine if direct current (DC) electrical stimulation of a metallic interbody fusion device enhanced the incidence or extent of anterior bony fusion. ALIF was performed using titanium alloy interbody fusion devices with and without adjunctive DC electrical stimulation in nonhuman primates. ALIF was performed through an anterolateral approach in 35 macaques with autogenous bone graft and either a titanium alloy (Ti-6Al-4V) fusion device or femoral allograft ring. The fusion devices of 19 animals received high (current density 19.6 microA/cm2) or low (current density 5.4 microA/cm2) DC electrical stimulation using an implanted generator for a 12- or 26-week evaluation period. Fusion sites were studied using serial radiographs, computed tomography imaging, nondestructive mechanical testing and qualitative and semiquantitative histology. Fusion was achieved with the titanium fusion device and autogenous bone graft. At 12 weeks, the graft was consolidating and early to moderate bridging callus was observed in and around the device. By 26 weeks, the anterior callus formation was more advanced with increased evidence of bridging trabeculations and early bone remodeling. The callus formation was not as advanced or abundant for the allograft ring group. Histology revealed the spinal fusion device had an 86% incidence of bony fusion at 26 weeks compared with a 50% fusion rate for the allograft rings. DC electrical stimulation of the fusion device had a positive effect on anterior interbody fusion by increasing both the presence and extent of bony fusion in a current density-dependent manner. Adjunctive DC electrical stimulation of the fusion device improved the rate and extent of bony fusion compared with a nonstimulated device. The fusion

Multiclassifier information fusion methods for microarray pattern recognition

NASA Astrophysics Data System (ADS)

Braun, Jerome J.; Glina, Yan; Judson, Nicholas; Herzig-Marx, Rachel

2004-04-01

This paper addresses automatic recognition of microarray patterns, a capability that could have a major significance for medical diagnostics, enabling development of diagnostic tools for automatic discrimination of specific diseases. The paper presents multiclassifier information fusion methods for microarray pattern recognition. The input space partitioning approach based on fitness measures that constitute an a-priori gauging of classification efficacy for each subspace is investigated. Methods for generation of fitness measures, generation of input subspaces and their use in the multiclassifier fusion architecture are presented. In particular, two-level quantification of fitness that accounts for the quality of each subspace as well as the quality of individual neighborhoods within the subspace is described. Individual-subspace classifiers are Support Vector Machine based. The decision fusion stage fuses the information from mulitple SVMs along with the multi-level fitness information. Final decision fusion stage techniques, including weighted fusion as well as Dempster-Shafer theory based fusion are investigated. It should be noted that while the above methods are discussed in the context of microarray pattern recognition, they are applicable to a broader range of discrimination problems, in particular to problems involving a large number of information sources irreducible to a low-dimensional feature space.

A survey of infrared and visual image fusion methods

NASA Astrophysics Data System (ADS)

Jin, Xin; Jiang, Qian; Yao, Shaowen; Zhou, Dongming; Nie, Rencan; Hai, Jinjin; He, Kangjian

2017-09-01

Infrared (IR) and visual (VI) image fusion is designed to fuse multiple source images into a comprehensive image to boost imaging quality and reduce redundancy information, which is widely used in various imaging equipment to improve the visual ability of human and robot. The accurate, reliable and complementary descriptions of the scene in fused images make these techniques be widely used in various fields. In recent years, a large number of fusion methods for IR and VI images have been proposed due to the ever-growing demands and the progress of image representation methods; however, there has not been published an integrated survey paper about this field in last several years. Therefore, we make a survey to report the algorithmic developments of IR and VI image fusion. In this paper, we first characterize the IR and VI image fusion based applications to represent an overview of the research status. Then we present a synthesize survey of the state of the art. Thirdly, the frequently-used image fusion quality measures are introduced. Fourthly, we perform some experiments of typical methods and make corresponding analysis. At last, we summarize the corresponding tendencies and challenges in IR and VI image fusion. This survey concludes that although various IR and VI image fusion methods have been proposed, there still exist further improvements or potential research directions in different applications of IR and VI image fusion.

Multisensor data fusion for physical activity assessment.

PubMed

Liu, Shaopeng; Gao, Robert X; John, Dinesh; Staudenmayer, John W; Freedson, Patty S

2012-03-01

This paper presents a sensor fusion method for assessing physical activity (PA) of human subjects, based on support vector machines (SVMs). Specifically, acceleration and ventilation measured by a wearable multisensor device on 50 test subjects performing 13 types of activities of varying intensities are analyzed, from which activity type and energy expenditure are derived. The results show that the method correctly recognized the 13 activity types 88.1% of the time, which is 12.3% higher than using a hip accelerometer alone. Also, the method predicted energy expenditure with a root mean square error of 0.42 METs, 22.2% lower than using a hip accelerometer alone. Furthermore, the fusion method was effective in reducing the subject-to-subject variability (standard deviation of recognition accuracies across subjects) in activity recognition, especially when data from the ventilation sensor were added to the fusion model. These results demonstrate that the multisensor fusion technique presented is more effective in identifying activity type and energy expenditure than the traditional accelerometer-alone-based methods.

Intravascular flow detection during transforaminal epidural injections: a prospective assessment.

PubMed

El Abd, Omar Hamman; Amadera, Joao Eduardo Daud; Pimentel, Daniel Camargo; Pimentel, Thais Spacov Camargo

2014-01-01

Transforaminal epidural steroid injections (TFESI) are a mainstay in the treatment of spine pain. Though this commonly performed procedure is generally felt to be safe, devastating complications following inadvertent intra-arterial injections of particulate steroid have been reported. The use of digital subtraction angiography (DSA) has been suggested as a means of detecting intra-arterial needle placements prior to medication injection. To examine the efficacy of DSA in detecting intra-arterial needle placements during TFESI. Prospective cohort study evaluating the impact of DSA on detecting intra-arterial needle placements during TFESI. We enrolled 150 consecutive patients presenting to a university-affiliated spine center with discogenic and/or radicular symptoms affecting the cervical, lumbar, and sacral regions. For each injection, prior to imaging with DSA, traditional methods for vascular penetration detection were employed, including the identification of blood in the needle hub (flash), negative aspiration of blood prior to injection, and live fluoroscopic injection of contrast. Once these tests were performed and negative for signs of intra-arterial needle placement, DSA imaging was utilized prior to medication administration for identification of vascular flow. A total number of 222 TFESI were performed, 41 injections at the cervical levels (18.47%), 113 at the lumbar levels (50.9%), and 68 at the sacral levels (30.36%). Flash was observed in 13 injections performed (5.85% of the total number of injections): one (0.45%) in the cervical, 2 (0.9%) in the lumbar, and 10 (4.5%) in the sacral levels. In 11 TFESI blood aspiration was obtained (4.95% of all injections): 3 (1.3%) in cervical, 4 (1.8%) in lumbar, and 4 (1.8%) in sacral injections. Live fluoroscopy during contrast injection detected 46 (20.72%) intravascular flow patterns: 7 (3.1%) cervical, 17 (7.6%) lumbar, and 22 (9.9%) sacral. DSA identified an additional 5 intravascular injections after all

Magnetic Resonance and Ultrasound Image Fusion Supported Transperineal Prostate Biopsy Using the Ginsburg Protocol: Technique, Learning Points, and Biopsy Results.

PubMed

Hansen, Nienke; Patruno, Giulio; Wadhwa, Karan; Gaziev, Gabriele; Miano, Roberto; Barrett, Tristan; Gnanapragasam, Vincent; Doble, Andrew; Warren, Anne; Bratt, Ola; Kastner, Christof

2016-08-01

high, prostate biopsies may not be needed for all men with elevated prostate-specific antigen values and nonsuspicious mpMRI. We present our technique to sample (biopsy) the prostate by the transperineal route (the area between the scrotum and the anus) to detect prostate cancer using a fusion of magnetic resonance and ultrasound images to guide the sampling. Copyright © 2016 European Association of Urology. All rights reserved.

Inner membrane fusion mediates spatial distribution of axonal mitochondria

PubMed Central

Yu, Yiyi; Lee, Hao-Chih; Chen, Kuan-Chieh; Suhan, Joseph; Qiu, Minhua; Ba, Qinle; Yang, Ge

2016-01-01

In eukaryotic cells, mitochondria form a dynamic interconnected network to respond to changing needs at different subcellular locations. A fundamental yet unanswered question regarding this network is whether, and if so how, local fusion and fission of individual mitochondria affect their global distribution. To address this question, we developed high-resolution computational image analysis techniques to examine the relations between mitochondrial fusion/fission and spatial distribution within the axon of Drosophila larval neurons. We found that stationary and moving mitochondria underwent fusion and fission regularly but followed different spatial distribution patterns and exhibited different morphology. Disruption of inner membrane fusion by knockdown of dOpa1, Drosophila Optic Atrophy 1, not only increased the spatial density of stationary and moving mitochondria but also changed their spatial distributions and morphology differentially. Knockdown of dOpa1 also impaired axonal transport of mitochondria. But the changed spatial distributions of mitochondria resulted primarily from disruption of inner membrane fusion because knockdown of Milton, a mitochondrial kinesin-1 adapter, caused similar transport velocity impairment but different spatial distributions. Together, our data reveals that stationary mitochondria within the axon interconnect with moving mitochondria through fusion and fission and that local inner membrane fusion between individual mitochondria mediates their global distribution. PMID:26742817

Fusion of Geophysical Images in the Study of Archaeological Sites

NASA Astrophysics Data System (ADS)

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

2011-12-01

This paper presents results from different fusion techniques between geophysical images from different modalities in order to combine them into one image with higher information content than the two original images independently. The resultant image will be useful for the detection and mapping of buried archaeological relics. The examined archaeological area is situated in Kampana site (NE Greece) near the ancient theater of Maronia city. Archaeological excavations revealed an ancient theater, an aristocratic house and the temple of the ancient Greek God Dionysus. Numerous ceramic objects found in the broader area indicated the probability of the existence of buried urban structure. In order to accurately locate and map the latter, geophysical measurements performed with the use of the magnetic method (vertical gradient of the magnetic field) and of the electrical method (apparent resistivity). We performed a semi-stochastic pixel based registration method between the geophysical images in order to fine register them by correcting their local spatial offsets produced by the use of hand held devices. After this procedure we applied to the registered images three different fusion approaches. Image fusion is a relatively new technique that not only allows integration of different information sources, but also takes advantage of the spatial and spectral resolution as well as the orientation characteristics of each image. We have used three different fusion techniques, fusion with mean values, with wavelets by enhancing selected frequency bands and curvelets giving emphasis at specific bands and angles (according the expecting orientation of the relics). In all three cases the fused images gave significantly better results than each of the original geophysical images separately. The comparison of the results of the three different approaches showed that the fusion with the use of curvelets, giving emphasis at the features' orientation, seems to give the best fused image

MicroRNA Detection by DNA-Mediated Liposome Fusion.

PubMed

Jumeaux, Coline; Wahlsten, Olov; Block, Stephan; Kim, Eunjung; Chandrawati, Rona; Howes, Philip D; Höök, Fredrik; Stevens, Molly M

2018-03-02

Membrane fusion is a process of fundamental importance in biological systems that involves highly selective recognition mechanisms for the trafficking of molecular and ionic cargos. Mimicking natural membrane fusion mechanisms for the purpose of biosensor development holds great potential for amplified detection because relatively few highly discriminating targets lead to fusion and an accompanied engagement of a large payload of signal-generating molecules. In this work, sequence-specific DNA-mediated liposome fusion is used for the highly selective detection of microRNA. The detection of miR-29a, a known flu biomarker, is demonstrated down to 18 nm within 30 min with high specificity by using a standard laboratory microplate reader. Furthermore, one order of magnitude improvement in the limit of detection is demonstrated by using a novel imaging technique combined with an intensity fluctuation analysis, which is coined two-color fluorescence correlation microscopy. © 2018 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

Fusion with stem cell makes the hepatocellular carcinoma cells similar to liver tumor-initiating cells.

PubMed

Wang, Ran; Chen, Shuxun; Li, Changxian; Ng, Kevin Tak Pan; Kong, Chi-wing; Cheng, Jinping; Cheng, Shuk Han; Li, Ronald A; Lo, Chung Mau; Man, Kwan; Sun, Dong

2016-02-04

Cell fusion is a fast and highly efficient technique for cells to acquire new properties. The fusion of somatic cells with stem cells can reprogram somatic cells to a pluripotent state. Our research on the fusion of stem cells and cancer cells demonstrates that the fused cells can exhibit stemness and cancer cell-like characteristics. Thus, tumor-initiating cell-like cells are generated. We employed laser-induced single-cell fusion technique to fuse the hepatocellular carcinoma cells and human embryonic stem cells (hESC). Real-time RT-PCR, flow cytometry and in vivo tumorigenicity assay were adopted to identify the gene expression difference. We successfully produced a fused cell line that coalesces the gene expression information of hepatocellular carcinoma cells and stem cells. Experimental results showed that the fused cells expressed cancer and stemness markers as well as exhibited increased resistance to drug treatment and enhanced tumorigenesis. Fusion with stem cells transforms liver cancer cells into tumor initiating-like cells. Results indicate that fusion between cancer cell and stem cell may generate tumor initiating-like cells.

Millimeter-wave imaging of magnetic fusion plasmas: technology innovations advancing physics understanding

NASA Astrophysics Data System (ADS)

Wang, Y.; Tobias, B.; Chang, Y.-T.; Yu, J.-H.; Li, M.; Hu, F.; Chen, M.; Mamidanna, M.; Phan, T.; Pham, A.-V.; Gu, J.; Liu, X.; Zhu, Y.; Domier, C. W.; Shi, L.; Valeo, E.; Kramer, G. J.; Kuwahara, D.; Nagayama, Y.; Mase, A.; Luhmann, N. C., Jr.

2017-07-01

Electron cyclotron emission (ECE) imaging is a passive radiometric technique that measures electron temperature fluctuations; and microwave imaging reflectometry (MIR) is an active radar imaging technique that measures electron density fluctuations. Microwave imaging diagnostic instruments employing these techniques have made important contributions to fusion science and have been adopted at major fusion facilities worldwide including DIII-D, EAST, ASDEX Upgrade, HL-2A, KSTAR, LHD, and J-TEXT. In this paper, we describe the development status of three major technological advancements: custom mm-wave integrated circuits (ICs), digital beamforming (DBF), and synthetic diagnostic modeling (SDM). These have the potential to greatly advance microwave fusion plasma imaging, enabling compact and low-noise transceiver systems with real-time, fast tracking ability to address critical fusion physics issues, including ELM suppression and disruptions in the ITER baseline scenario, naturally ELM-free states such as QH-mode, and energetic particle confinement (i.e. Alfvén eigenmode stability) in high-performance regimes that include steady-state and advanced tokamak scenarios. Furthermore, these systems are fully compatible with today’s most challenging non-inductive heating and current drive systems and capable of operating in harsh environments, making them the ideal approach for diagnosing long-pulse and steady-state tokamaks.

Millimeter-wave imaging of magnetic fusion plasmas: technology innovations advancing physics understanding

DOE PAGES

Wang, Y.; Tobias, B.; Chang, Y. -T.; ...

2017-03-14

Electron cyclotron emission (ECE) imaging is a passive radiometric technique that measures electron temperature fluctuations; and microwave imaging reflectometry (MIR) is an active radar imaging technique that measures electron density fluctuations. The microwave imaging diagnostic instruments employing these techniques have made important contributions to fusion science and have been adopted at major fusion facilities worldwide including DIII-D, EAST, ASDEX Upgrade, HL-2A, KSTAR, LHD, and J-TEXT. In this paper, we describe the development status of three major technological advancements: custom mm-wave integrated circuits (ICs), digital beamforming (DBF), and synthetic diagnostic modeling (SDM). These also have the potential to greatly advance microwavemore » fusion plasma imaging, enabling compact and low-noise transceiver systems with real-time, fast tracking ability to address critical fusion physics issues, including ELM suppression and disruptions in the ITER baseline scenario, naturally ELM-free states such as QH-mode, and energetic particle confinement (i.e. Alfven eigenmode stability) in high-performance regimes that include steady-state and advanced tokamak scenarios. Furthermore, these systems are fully compatible with today's most challenging non-inductive heating and current drive systems and capable of operating in harsh environments, making them the ideal approach for diagnosing long-pulse and steady-state tokamaks.« less

Design and Evaluation of Fusion Approach for Combining Brain and Gaze Inputs for Target Selection

PubMed Central

Évain, Andéol; Argelaguet, Ferran; Casiez, Géry; Roussel, Nicolas; Lécuyer, Anatole

2016-01-01

Gaze-based interfaces and Brain-Computer Interfaces (BCIs) allow for hands-free human–computer interaction. In this paper, we investigate the combination of gaze and BCIs. We propose a novel selection technique for 2D target acquisition based on input fusion. This new approach combines the probabilistic models for each input, in order to better estimate the intent of the user. We evaluated its performance against the existing gaze and brain–computer interaction techniques. Twelve participants took part in our study, in which they had to search and select 2D targets with each of the evaluated techniques. Our fusion-based hybrid interaction technique was found to be more reliable than the previous gaze and BCI hybrid interaction techniques for 10 participants over 12, while being 29% faster on average. However, similarly to what has been observed in hybrid gaze-and-speech interaction, gaze-only interaction technique still provides the best performance. Our results should encourage the use of input fusion, as opposed to sequential interaction, in order to design better hybrid interfaces. PMID:27774048

Lights on: Dye dequenching reveals polymersome fusion with polymer, lipid and stealth lipid vesicles

DOE PAGES

Henderson, Ian M.; Collins, Aaron M.; Quintana, Hope A.; ...

2015-12-13

In this study, we develop a quantitative dye dequenching technique for the measurement of polymersome fusion, using it to characterize the salt mediated, mechanically-induced fusion of polymersomes with polymer, lipid, and so-called stealth lipid vesicles. While dye dequenching has been used to quantitatively explore liposome fusion in the past, this is the first use of dye dequenching to measure polymersome fusion of which we are aware. In addition to providing quantitative results, dye dequenching is ideal for detecting fusion in instances where DLS results would be ambiguous, such as low yield levels and size ranges outside the capabilities of DLS.more » The dye chosen for this study was a cyanine derivative, 1,1'-dioctadecyl-3,3,3',3'-tetramethylindotricarbocyanine iodide (DiR), which proved to provide excellent data on the extent of polymersome fusion. Using this technique, we have shown the limited fusion capabilities of polymersome/liposome heterofusion, notably DOPC vesicles fusing with polymersomes at half the efficiency of polymersome homofusion and DPPC vesicles showing virtually no fusion. In addition to these key heterofusion experiments, we determined the broad applicability of dye dequenching in measuring kinetic rates of polymersome fusion; and showed that even at elevated temperatures or over multiple weeks' time, no polymersome fusion occurred without agitation. Stealth liposomes formed from DPPC and PEO-functionalized lipid, however, fused with polymersomes and stealth liposomes with relatively high efficiency, lending support to our hypothesis that the response of the PEO corona to salt is a key factor in the fusion process. This last finding suggests that although the conjugation of PEO to lipids increases vesicle biocompatibility and enables their longer circulation times, it also renders the vesicles subject to destabilization under high salt and shear (e.g. in the circulatory system) that may lead to, in this case, fusion.« less

Improving cerebellar segmentation with statistical fusion

NASA Astrophysics Data System (ADS)

Plassard, Andrew J.; Yang, Zhen; Prince, Jerry L.; Claassen, Daniel O.; Landman, Bennett A.

2016-03-01

The cerebellum is a somatotopically organized central component of the central nervous system well known to be involved with motor coordination and increasingly recognized roles in cognition and planning. Recent work in multiatlas labeling has created methods that offer the potential for fully automated 3-D parcellation of the cerebellar lobules and vermis (which are organizationally equivalent to cortical gray matter areas). This work explores the trade offs of using different statistical fusion techniques and post hoc optimizations in two datasets with distinct imaging protocols. We offer a novel fusion technique by extending the ideas of the Selective and Iterative Method for Performance Level Estimation (SIMPLE) to a patch-based performance model. We demonstrate the effectiveness of our algorithm, Non- Local SIMPLE, for segmentation of a mixed population of healthy subjects and patients with severe cerebellar anatomy. Under the first imaging protocol, we show that Non-Local SIMPLE outperforms previous gold-standard segmentation techniques. In the second imaging protocol, we show that Non-Local SIMPLE outperforms previous gold standard techniques but is outperformed by a non-locally weighted vote with the deeper population of atlases available. This work advances the state of the art in open source cerebellar segmentation algorithms and offers the opportunity for routinely including cerebellar segmentation in magnetic resonance imaging studies that acquire whole brain T1-weighted volumes with approximately 1 mm isotropic resolution.

Fusion power: a challenge for materials science.

PubMed

Duffy, D M

2010-07-28

The selection and design of materials that will withstand the extreme conditions of a fusion power plant has been described as one of the greatest materials science challenges in history. The high particle flux, high thermal load, thermal mechanical stress and the production of transmutation elements combine to produce a uniquely hostile environment. In this paper, the materials favoured for the diverse roles in a fusion power plant are discussed, along with the experimental and modelling techniques that are used to advance the understanding of radiation damage in materials. Areas where further research is necessary are highlighted.

Prospects for Attractive Fusion Power

NASA Astrophysics Data System (ADS)

Najmabadi, Farrokh

2006-10-01

During the past ten years, the ARIES Team, a national team involving universities, national laboratories, and industry, has studied a variety of magnetic fusion power plants (tokamaks, stellarators, ST, and RFP). In this paper, we present the top-level requirements and goals for commercial fusion power plants developed with consultation with US utilities and industry. We will review several ARIES designs and discuss the candidate options for physics operation regime as well engineering design of various components (e.g., choice of structural material, coolant, breeder). For each option, we will discuss (1) the potential to satisfy the requirements and goals, and (2) the critical R&D needs. In particular, we will discuss fusion R&D issues which are similar to those of advanced fission systems. For tokamaks, our results indicate that dramatic improvement over first-stability operation can be obtained through either utilization of high-field magnets (e.g., high-temperature superconductors) or operation in advanced-tokamak modes (e.g., reversed-shear). In particular, if full benefits of reversed-shear operation are realized, as is assumed in ARIES-AT, tokamak power plants will have a cost of electricity competitive with other sources of electricity. Emerging technologies such as advanced Baryon cycle, high-temperature superconductor, and advanced manufacturing techniques can improve the cost and attractiveness of fusion plants.

Data fusion for delivering advanced traveler information services

DOT National Transportation Integrated Search

2003-05-01

Many transportation professionals have suggested that improved ATIS data fusion techniques and processing will improve the overall quality, timeliness, and usefulness of traveler information. The purpose of this study was four fold. First, conduct a ...

Early and late HIV-1 membrane fusion events are impaired by sphinganine lipidated peptides that target the fusion site.

PubMed

Klug, Yoel A; Ashkenazi, Avraham; Viard, Mathias; Porat, Ziv; Blumenthal, Robert; Shai, Yechiel

2014-07-15

Lipid-conjugated peptides have advanced the understanding of membrane protein functions and the roles of lipids in the membrane milieu. These lipopeptides modulate various biological systems such as viral fusion. A single function has been suggested for the lipid, binding to the membrane and thus elevating the local concentration of the peptide at the target site. In the present paper, we challenged this argument by exploring in-depth the antiviral mechanism of lipopeptides, which comprise sphinganine, the lipid backbone of DHSM (dihydrosphingomyelin), and an HIV-1 envelope-derived peptide. Surprisingly, we discovered a partnership between the lipid and the peptide that impaired early membrane fusion events by reducing CD4 receptor lateral diffusion and HIV-1 fusion peptide-mediated lipid mixing. Moreover, only the joint function of sphinganine and its conjugate peptide disrupted HIV-1 fusion protein assembly and folding at the later fusion steps. Via imaging techniques we revealed for the first time the direct localization of these lipopeptides to the virus-cell and cell-cell contact sites. Overall, the findings of the present study may suggest lipid-protein interactions in various biological systems and may help uncover a role for elevated DHSM in HIV-1 and its target cell membranes.

Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion.

PubMed

Ledonio, Charles Gt; Polly, David W; Swiontkowski, Marc F; Cummings, John T

2014-01-01

The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS) surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI) outcomes associated with each of these techniques. A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher's exact test and two nonparametric tests, ie, the Mann-Whitney U test and the Wilcoxon signed-rank test. The results are presented as percent or median with range, as appropriate. Forty-nine patients from two institutions underwent sacroiliac joint fusion between 2006 and 2012. Ten patients were excluded because of incomplete data, leaving 39 evaluable patients, of whom 22 underwent open and 17 underwent MIS sacroiliac joint fusion. The MIS group was significantly older (median age 66 [39-82] years) than the open group (median age 51 [34-74] years). Surgical time and hospital stay were significantly shorter in the MIS group than in the open group. Preoperative ODI was significantly greater in the open group (median 64 [44-78]) than in the MIS group (median 53 [14-84]). Postoperative improvement in ODI was statistically significant within and between groups, with MIS resulting in greater improvement. The open and MIS sacroiliac joint fusion techniques resulted in statistically and clinically significant improvement for patients with degenerative sacroiliitis refractory to nonoperative management. However, the number of patients

High Level Information Fusion (HLIF) with nested fusion loops

NASA Astrophysics Data System (ADS)

Woodley, Robert; Gosnell, Michael; Fischer, Amber

2013-05-01

Situation modeling and threat prediction require higher levels of data fusion in order to provide actionable information. Beyond the sensor data and sources the analyst has access to, the use of out-sourced and re-sourced data is becoming common. Through the years, some common frameworks have emerged for dealing with information fusion—perhaps the most ubiquitous being the JDL Data Fusion Group and their initial 4-level data fusion model. Since these initial developments, numerous models of information fusion have emerged, hoping to better capture the human-centric process of data analyses within a machine-centric framework. 21st Century Systems, Inc. has developed Fusion with Uncertainty Reasoning using Nested Assessment Characterizer Elements (FURNACE) to address challenges of high level information fusion and handle bias, ambiguity, and uncertainty (BAU) for Situation Modeling, Threat Modeling, and Threat Prediction. It combines JDL fusion levels with nested fusion loops and state-of-the-art data reasoning. Initial research has shown that FURNACE is able to reduce BAU and improve the fusion process by allowing high level information fusion (HLIF) to affect lower levels without the double counting of information or other biasing issues. The initial FURNACE project was focused on the underlying algorithms to produce a fusion system able to handle BAU and repurposed data in a cohesive manner. FURNACE supports analyst's efforts to develop situation models, threat models, and threat predictions to increase situational awareness of the battlespace. FURNACE will not only revolutionize the military intelligence realm, but also benefit the larger homeland defense, law enforcement, and business intelligence markets.

Production and characterization of pure cryogenic inertial fusion targets

NASA Astrophysics Data System (ADS)

Boyd, B. A.; Kamerman, G. W.

An experimental cryogenic inertial fusion target generator and two optical techniques for automated target inspection are described. The generator produces 100 microns diameter solid hydrogen spheres at a rate compatible with fueling requirements of conceptual inertial fusion power plants. A jet of liquified hydrogen is disrupted into droplets by an ultrasonically excited nozzle. The droplets solidify into microspheres while falling through a chamber maintained below the hydrogen triple point pressure. Stable operation of the generator has been demonstrated for up to three hours. The optical inspection techniques are computer aided photomicrography and coarse diffraction pattern analysis (CDPA). The photomicrography system uses a conventional microscope coupled to a computer by a solid state camera and digital image memory. The computer enhances the stored image and performs feature extraction to determine pellet parameters. The CDPA technique uses Fourier transform optics and a special detector array to perform optical processing of a target image.

Feature and Score Fusion Based Multiple Classifier Selection for Iris Recognition

PubMed Central

Islam, Md. Rabiul

2014-01-01

The aim of this work is to propose a new feature and score fusion based iris recognition approach where voting method on Multiple Classifier Selection technique has been applied. Four Discrete Hidden Markov Model classifiers output, that is, left iris based unimodal system, right iris based unimodal system, left-right iris feature fusion based multimodal system, and left-right iris likelihood ratio score fusion based multimodal system, is combined using voting method to achieve the final recognition result. CASIA-IrisV4 database has been used to measure the performance of the proposed system with various dimensions. Experimental results show the versatility of the proposed system of four different classifiers with various dimensions. Finally, recognition accuracy of the proposed system has been compared with existing N hamming distance score fusion approach proposed by Ma et al., log-likelihood ratio score fusion approach proposed by Schmid et al., and single level feature fusion approach proposed by Hollingsworth et al. PMID:25114676

Feature and score fusion based multiple classifier selection for iris recognition.

PubMed

Islam, Md Rabiul

2014-01-01

The aim of this work is to propose a new feature and score fusion based iris recognition approach where voting method on Multiple Classifier Selection technique has been applied. Four Discrete Hidden Markov Model classifiers output, that is, left iris based unimodal system, right iris based unimodal system, left-right iris feature fusion based multimodal system, and left-right iris likelihood ratio score fusion based multimodal system, is combined using voting method to achieve the final recognition result. CASIA-IrisV4 database has been used to measure the performance of the proposed system with various dimensions. Experimental results show the versatility of the proposed system of four different classifiers with various dimensions. Finally, recognition accuracy of the proposed system has been compared with existing N hamming distance score fusion approach proposed by Ma et al., log-likelihood ratio score fusion approach proposed by Schmid et al., and single level feature fusion approach proposed by Hollingsworth et al.

Kits and methods of detection using cellulose binding domain fusion proteins

DOEpatents

Shoseyov, O.; Yosef, K.

1998-04-14

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.

Kits and methods of detection using cellulose binding domain fusion proteins

DOEpatents

Shoseyov, Oded

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.

Local bone graft harvesting and volumes in posterolateral lumbar fusion: a technical report.

PubMed

Carragee, Eugene J; Comer, Garet C; Smith, Micah W

2011-06-01

In lumbar surgery, local bone graft is often harvested and used in posterolateral fusion procedures. The volume of local bone graft available for posterolateral fusion has not been determined in North American patients. Some authors have described this as minimal, but others have suggested the volume was sufficient to be reliably used as a stand-alone bone graft substitute for single-level fusion. To describe the technique used and determine the volume of local bone graft available in a cohort of patients undergoing single-level primary posterolateral fusion by the authors harvesting technique. Technical description and cohort report. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes. Local bone graft volume. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes of were studied. Local bone graft was harvested by a standard method in each patient and the volume measured by a standard procedure. Twenty-five patients were studied, and of these 11 (44%) had a previous decompression. The mean volume of local bone graft harvested was measured to be 25 cc (range, 12-36 cc). Local bone graft was augmented by iliac crest bone in six of 25 patients (24%) if the posterolateral fusion bed was not well packed with local bone alone. There was a trend to greater local bone graft volumes in men and in patients without previous decompression. Large volumes of local bone can be harvested during posterolateral lumbar fusion surgery. Even in patients with previous decompression the volume harvested is similar to that reported harvested from the posterior iliac crest for single-level fusion. Copyright © 2011 Elsevier Inc. All rights reserved.

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

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.

The emissivities of liquid metals at their fusion temperatures

NASA Technical Reports Server (NTRS)

Bonnell, D. W.; Treverton, J. A.; Valerga, A. J.; Margrave, J. L.

1972-01-01

A survey of the literature through 1969 shows an almost total lack of experimental emissivity data for metals in the liquid state. The emissivities for several transition metals and various other metals and compounds in the liquid state at their fusion temperatures have been determined. The technique used involves electromagnetic levitation-induction heating of the materials in an inert atmosphere. The brightness temperature of the liquid phase of the material is measured as the material is heated through fusion. Given a reliable value of the fusion temperature, which is available for most pure substances, one may readily calculate an emissivity for the liquid phase at the fusion temperatures. Even in cases where melting points are poorly known, the brightness temperatures are unique parameters, independent of the temperature scale and measured for a chemically defined system at a fixed point. Better emissivities may be recalculated as better melting point data become available.

Fusion of laser and image sensory data for 3-D modeling of the free navigation space

NASA Technical Reports Server (NTRS)

Mass, M.; Moghaddamzadeh, A.; Bourbakis, N.

1994-01-01

A fusion technique which combines two different types of sensory data for 3-D modeling of a navigation space is presented. The sensory data is generated by a vision camera and a laser scanner. The problem of different resolutions for these sensory data was solved by reduced image resolution, fusion of different data, and use of a fuzzy image segmentation technique.

Paravertebral foramen screw fixation for posterior cervical spine fusion: biomechanical study and description of a novel technique.

PubMed

Maki, Satoshi; Aramomi, Masaaki; Matsuura, Yusuke; Furuya, Takeo; Ota, Mitsutoshi; Iijima, Yasushi; Saito, Junya; Suzuki, Takane; Mannoji, Chikato; Takahashi, Kazuhisa; Yamazaki, Masashi; Koda, Masao

2017-10-01

OBJECTIVE Fusion surgery with instrumentation is a widely accepted treatment for cervical spine pathologies. The authors propose a novel technique for subaxial cervical fusion surgery using paravertebral foramen screws (PVFS). The authors consider that PVFS have equal or greater biomechanical strength than lateral mass screws (LMS). The authors' goals of this study were to conduct a biomechanical study of PVFS, to investigate the suitability of PVFS as salvage fixation for failed LMS, and to describe this novel technique. METHODS The authors harvested 24 human cervical spine vertebrae (C3-6) from 6 fresh-frozen cadaver specimens from donors whose mean age was 84.3 ± 10.4 years at death. For each vertebra, one side was chosen randomly for PVFS and the other for LMS. For PVFS, a 3.2-mm drill with a stopper was advanced under lateral fluoroscopic imaging. The drill stopper was set to 12 mm, which was considered sufficiently short not to breach the transverse foramen. The drill was directed from 20° to 25° medially so that the screw could purchase the relatively hard cancellous bone around the entry zone of the pedicle. The hole was tapped and a 4.5-mm-diameter × 12-mm screw was inserted. For LMS, 3.5-mm-diameter × 14-mm screws were inserted into the lateral mass of C3-6. The pullout strength of each screw was measured. After pullout testing of LMS, a drill was inserted into the screw hole and the superior cortex of the lateral mass was pried to cause a fracture through the screw hole, simulating intraoperative fracture of the lateral mass. After the procedure, PVFS for salvage (sPVFS) were inserted on the same side and pullout strength was measured. RESULTS The CT scans obtained after screw insertion revealed no sign of pedicle breaching, violation of the transverse foramen, or fracture of the lateral mass. A total of 69 screws were tested (23 PVFS, 23 LMS, and 23 sPVFS). One vertebra was not used because of a fracture that occurred while the specimen was

Adaptive fusion of infrared and visible images in dynamic scene

NASA Astrophysics Data System (ADS)

Yang, Guang; Yin, Yafeng; Man, Hong; Desai, Sachi

2011-11-01

Multiple modalities sensor fusion has been widely employed in various surveillance and military applications. A variety of image fusion techniques including PCA, wavelet, curvelet and HSV has been proposed in recent years to improve human visual perception for object detection. One of the main challenges for visible and infrared image fusion is to automatically determine an optimal fusion strategy for different input scenes along with an acceptable computational cost. This paper, we propose a fast and adaptive feature selection based image fusion method to obtain high a contrast image from visible and infrared sensors for targets detection. At first, fuzzy c-means clustering is applied on the infrared image to highlight possible hotspot regions, which will be considered as potential targets' locations. After that, the region surrounding the target area is segmented as the background regions. Then image fusion is locally applied on the selected target and background regions by computing different linear combination of color components from registered visible and infrared images. After obtaining different fused images, histogram distributions are computed on these local fusion images as the fusion feature set. The variance ratio which is based on Linear Discriminative Analysis (LDA) measure is employed to sort the feature set and the most discriminative one is selected for the whole image fusion. As the feature selection is performed over time, the process will dynamically determine the most suitable feature for the image fusion in different scenes. Experiment is conducted on the OSU Color-Thermal database, and TNO Human Factor dataset. The fusion results indicate that our proposed method achieved a competitive performance compared with other fusion algorithms at a relatively low computational cost.

The applicability of holography in forensic identification: a fusion of the traditional optical technique and digital technique.

PubMed

Biwasaka, Hitoshi; Saigusa, Kiyoshi; Aoki, Yasuhiro

2005-03-01

In this study, the applicability of holography in the 3-dimensional recording of forensic objects such as skulls and mandibulae, and the accuracy of the reconstructed 3-D images, were examined. The virtual holographic image, which records the 3-dimensional data of the original object, is visually observed on the other side of the holographic plate, and reproduces the 3-dimensional shape of the object well. Another type of holographic image, the real image, is focused on a frosted glass screen, and cross-sectional images of the object can be observed. When measuring the distances between anatomical reference points using an image-processing software, the average deviations in the holographic images as compared to the actual objects were less than 0.1 mm. Therefore, holography could be useful as a 3-dimensional recording method of forensic objects. Two superimposition systems using holographic images were examined. In the 2D-3D system, the transparent virtual holographic image of an object is directly superimposed onto the digitized photograph of the same object on the LCD monitor. On the other hand, in the video system, the holographic image captured by the CCD camera is superimposed onto the digitized photographic image using a personal computer. We found that the discrepancy between the outlines of the superimposed holographic and photographic dental images using the video system was smaller than that using the 2D-3D system. Holography seemed to perform comparably to the computer graphic system; however, a fusion with the digital technique would expand the utility of holography in superimposition.

Dual wavelength imaging allows analysis of membrane fusion of influenza virus inside cells.

PubMed

Sakai, Tatsuya; Ohuchi, Masanobu; Imai, Masaki; Mizuno, Takafumi; Kawasaki, Kazunori; Kuroda, Kazumichi; Yamashina, Shohei

2006-02-01

Influenza virus hemagglutinin (HA) is a determinant of virus infectivity. Therefore, it is important to determine whether HA of a new influenza virus, which can potentially cause pandemics, is functional against human cells. The novel imaging technique reported here allows rapid analysis of HA function by visualizing viral fusion inside cells. This imaging was designed to detect fusion changing the spectrum of the fluorescence-labeled virus. Using this imaging, we detected the fusion between a virus and a very small endosome that could not be detected previously, indicating that the imaging allows highly sensitive detection of viral fusion.

Fusion breeder

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moir, R.W.

1982-02-22

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 outlinemore » specific research and development goals so that the fusion breeder will be developed in time to meet fissile fuel needs.« less

Fusion breeder

DOE Office of Scientific and Technical Information (OSTI.GOV)

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 outlinemore » specific research and development goals so that the fusion breeder will be developed in time to meet fissile fuel needs.« less

Fusion of Visible and Thermal Descriptors Using Genetic Algorithms for Face Recognition Systems.

PubMed

Hermosilla, Gabriel; Gallardo, Francisco; Farias, Gonzalo; San Martin, Cesar

2015-07-23

The aim of this article is to present a new face recognition system based on the fusion of visible and thermal features obtained from the most current local matching descriptors by maximizing face recognition rates through the use of genetic algorithms. The article considers a comparison of the performance of the proposed fusion methodology against five current face recognition methods and classic fusion techniques used commonly in the literature. These were selected by considering their performance in face recognition. The five local matching methods and the proposed fusion methodology are evaluated using the standard visible/thermal database, the Equinox database, along with a new database, the PUCV-VTF, designed for visible-thermal studies in face recognition and described for the first time in this work. The latter is created considering visible and thermal image sensors with different real-world conditions, such as variations in illumination, facial expression, pose, occlusion, etc. The main conclusions of this article are that two variants of the proposed fusion methodology surpass current face recognition methods and the classic fusion techniques reported in the literature, attaining recognition rates of over 97% and 99% for the Equinox and PUCV-VTF databases, respectively. The fusion methodology is very robust to illumination and expression changes, as it combines thermal and visible information efficiently by using genetic algorithms, thus allowing it to choose optimal face areas where one spectrum is more representative than the other.

Fusion of Visible and Thermal Descriptors Using Genetic Algorithms for Face Recognition Systems

PubMed Central

Hermosilla, Gabriel; Gallardo, Francisco; Farias, Gonzalo; San Martin, Cesar

2015-01-01

The aim of this article is to present a new face recognition system based on the fusion of visible and thermal features obtained from the most current local matching descriptors by maximizing face recognition rates through the use of genetic algorithms. The article considers a comparison of the performance of the proposed fusion methodology against five current face recognition methods and classic fusion techniques used commonly in the literature. These were selected by considering their performance in face recognition. The five local matching methods and the proposed fusion methodology are evaluated using the standard visible/thermal database, the Equinox database, along with a new database, the PUCV-VTF, designed for visible-thermal studies in face recognition and described for the first time in this work. The latter is created considering visible and thermal image sensors with different real-world conditions, such as variations in illumination, facial expression, pose, occlusion, etc. The main conclusions of this article are that two variants of the proposed fusion methodology surpass current face recognition methods and the classic fusion techniques reported in the literature, attaining recognition rates of over 97% and 99% for the Equinox and PUCV-VTF databases, respectively. The fusion methodology is very robust to illumination and expression changes, as it combines thermal and visible information efficiently by using genetic algorithms, thus allowing it to choose optimal face areas where one spectrum is more representative than the other. PMID:26213932

Viral membrane fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harrison, Stephen C., E-mail: harrison@crystal.harvard.edu

2015-05-15

Membrane fusion is an essential step when enveloped viruses enter cells. Lipid bilayer fusion requires catalysis to overcome a high kinetic barrier; viral fusion proteins are the agents that fulfill this catalytic function. Despite a variety of molecular architectures, these proteins facilitate fusion by essentially the same generic mechanism. Stimulated by a signal associated with arrival at the cell to be infected (e.g., receptor or co-receptor binding, proton binding in an endosome), they undergo a series of conformational changes. A hydrophobic segment (a “fusion loop” or “fusion peptide”) engages the target-cell membrane and collapse of the bridging intermediate thus formedmore » draws the two membranes (virus and cell) together. We know of three structural classes for viral fusion proteins. Structures for both pre- and postfusion conformations of illustrate the beginning and end points of a process that can be probed by single-virion measurements of fusion kinetics. - Highlights: • Viral fusion proteins overcome the high energy barrier to lipid bilayer merger. • Different molecular structures but the same catalytic mechanism. • Review describes properties of three known fusion-protein structural classes. • Single-virion fusion experiments elucidate mechanism.« less

Paramyxovirus fusion: Real-time measurement of parainfluenza virus 5 virus-cell fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Connolly, Sarah A.; Lamb, Robert A.

2006-11-25

Although cell-cell fusion assays are useful surrogate methods for studying virus fusion, differences between cell-cell and virus-cell fusion exist. To examine paramyxovirus fusion in real time, we labeled viruses with fluorescent lipid probes and monitored virus-cell fusion by fluorimetry. Two parainfluenza virus 5 (PIV5) isolates (W3A and SER) and PIV5 containing mutations within the fusion protein (F) were studied. Fusion was specific and temperature-dependent. Compared to many low pH-dependent viruses, the kinetics of PIV5 fusion was slow, approaching completion within several minutes. As predicted from cell-cell fusion assays, virus containing an F protein with an extended cytoplasmic tail (rSV5 F551)more » had reduced fusion compared to wild-type virus (W3A). In contrast, virus-cell fusion for SER occurred at near wild-type levels, despite the fact that this isolate exhibits a severely reduced cell-cell fusion phenotype. These results support the notion that virus-cell and cell-cell fusion have significant differences.« less

Lordosis Re-Creation in TLIF and PLIF: A Cadaveric Study of the Influence of Surgical Bone Resection and Cage Angle.

PubMed

Robertson, Peter A; Armstrong, William A; Woods, Daniel L; Rawlinson, Jeremy J

2018-04-24

Controlled cadaveric study of surgical technique in Transforaminal and Posterior Lumbar Interbody Fusion (TLIF & PLIF) OBJECTIVE.: To evaluate the contribution of surgical techniques and cage variables in lordosis re-creation in posterior interbody fusion (TLIF/PLIF). The major contributors to lumbar lordosis are the lordotic lower lumbar discs. The pathologies requiring treatment with segmental fusion are frequently hypolordotic or kyphotic. Current posterior based interbody techniques have a poor track record for recreating lordosis, although re-creation of lordosis with optimum anatomical alignment is associated with better outcomes and reduced adjacent segment change needing revision. It is unclear whether surgical techniques or cage parameters contribute significantly to lordosis re-creation. Eight instrumented cadaveric motion segments were evaluated with pre and post experimental radiological assessment of lordosis. Each motion segment was instrumented with pedicle screw fixation to allow segmental stabilization. The surgical procedures were unilateral TLIF with an 18° lordotic and 27 mm length cage, unilateral TLIF (18°, 27 mm) with bilateral facetectomy, unilateral TLIF (18°, 27 mm) with posterior column osteotomy, PLIF with bilateral cages (18°, 22 mm), and PLIF with bilateral cages (24°, 22 mm). Cage insertion used and 'insert and rotate' technique. Pooled results demonstrated a mean increase in lordosis of 2.2° with each procedural step (Lordosis increase was serially 1.8°, 3.5°, 1.6°, 2.5° & 1.6° through the procedures). TLIF and PLIF with posterior column osteotomy increased lordosis significantly compared with Unilateral TLIF and TLIF with bilateral facetectomy. The major contributors to lordosis re-creation were posterior column osteotomy, and PLIF with paired shorter cages rather than TLIF. This study demonstrates that the surgical approach to posterior interbody surgery influences lordosis gain and posterior column osteotomy

Multisource data fusion for documenting archaeological sites

NASA Astrophysics Data System (ADS)

Knyaz, Vladimir; Chibunichev, Alexander; Zhuravlev, Denis

2017-10-01

The quality of archaeological sites documenting is of great importance for cultural heritage preserving and investigating. The progress in developing new techniques and systems for data acquisition and processing creates an excellent basis for achieving a new quality of archaeological sites documenting and visualization. archaeological data has some specific features which have to be taken into account when acquiring, processing and managing. First of all, it is a needed to gather as full as possible information about findings providing no loss of information and no damage to artifacts. Remote sensing technologies are the most adequate and powerful means which satisfy this requirement. An approach to archaeological data acquiring and fusion based on remote sensing is proposed. It combines a set of photogrammetric techniques for obtaining geometrical and visual information at different scales and detailing and a pipeline for archaeological data documenting, structuring, fusion, and analysis. The proposed approach is applied for documenting of Bosporus archaeological expedition of Russian State Historical Museum.

Outcome of L5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high-grade L5-S1 isthmic spondylolisthesis and the role of intraoperative neurophysiological monitoring.

PubMed

Schär, Ralph T; Sutter, Martin; Mannion, Anne F; Eggspühler, Andreas; Jeszenszky, Dezsö; Fekete, Tamas F; Kleinstück, Frank; Haschtmann, Daniel

2017-03-01

To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5-S1 isthmic spondylolisthesis and the role of intraoperative neurophysiological monitoring (IONM). Consecutive patients treated for high-grade spondylolisthesis with IONM from 2005 to 2013 were screened for eligibility. Prospectively collected clinical and surgical data as well as radiographic outcomes were analyzed retrospectively. Patients completed the multidimensional Core Outcome Measures Index (COMI) before and at 3, 12, and 24 months after surgery. Seventeen patients were included, with a mean age of 26.3 (±9.5) years. Mean preoperative L5-S1 slip was 72% (±21%) and was reduced to 19% (±13%) postoperatively. Mean loss of reduction at last follow-up [mean 19 months (±14, range 3-48 months)] was 3% (±4.3%). Rate of new L5 radiculopathy with motor deficit (L5MD) after surgery was 29% (five patients). Four patients fully recovered after 3 months, one patient was lost to neurologic follow-up. IONM sensitivity and specificity for postoperative L5MD was 20 and 100%, respectively. COMI, back pain and leg pain scores showed significant (p < 0.001) improvements at 3 months postoperatively, which were retained up to 24 months postoperatively. Transient L5 radiculopathy after reduction and instrumented fusion of high-grade spondylolisthesis is frequent. With IONM the risk of irreversible L5 radiculopathy is minimal. If IONM signal changes recover, full clinical recovery is expected within 3 months. Overall, patient-reported outcome of reduction and instrumented fusion of high-grade spondylolisthesis showed clinically important improvement.

Evaluation of a data fusion approach to estimate daily PM2.5 levels in North China

PubMed Central

Liang, Fengchao; Gao, Meng; Xiao, Qingyang; Carmichael, Gregory R.

2017-01-01

PM2.5 air pollution has been a growing concern worldwide. Previous studies have conducted several techniques to estimate PM2.5 exposure spatiotemporally in China, but all these have limitations. This study was to develop a data fusion approach and compare it with kriging and Chemistry Module. Two techniques were applied to create daily spatial cover of PM2.5 in grid cells with a resolution of 10 km in North China in 2013, respectively, which was kriging with an external drift (KED) and Weather Research and Forecast Model with Chemistry Module (WRF-Chem). A data fusion technique was developed by fusing PM2.5 concentration predicted by KED and WRF-Chem, accounting for the distance from the central of grid cell to the nearest ground observations and daily spatial correlations between WRF-Chem and observations. Model performances were evaluated by comparing them with ground observations and the spatial prediction errors. KED and data fusion performed better at monitoring sites with a daily model R2 of 0.95 and 0.94, respectively and PM2.5 was overestimated by WRF-Chem (R2=0.51). KED and data fusion performed better around the ground monitors, WRF-Chem performed relative worse with high prediction errors in the central of study domain. In our study, both KED and data fusion technique provided highly accurate PM2.5. Current monitoring network in North China was dense enough to provide a reliable PM2.5 prediction by interpolation technique. PMID:28599195

Evaluation of a data fusion approach to estimate daily PM2.5 levels in North China.

PubMed

Liang, Fengchao; Gao, Meng; Xiao, Qingyang; Carmichael, Gregory R; Pan, Xiaochuan; Liu, Yang

2017-10-01

PM 2.5 air pollution has been a growing concern worldwide. Previous studies have conducted several techniques to estimate PM 2.5 exposure spatiotemporally in China, but all these have limitations. This study was to develop a data fusion approach and compare it with kriging and Chemistry Module. Two techniques were applied to create daily spatial cover of PM 2.5 in grid cells with a resolution of 10km in North China in 2013, respectively, which was kriging with an external drift (KED) and Weather Research and Forecast Model with Chemistry Module (WRF-Chem). A data fusion technique was developed by fusing PM 2.5 concentration predicted by KED and WRF-Chem, accounting for the distance from the central of grid cell to the nearest ground observations and daily spatial correlations between WRF-Chem and observations. Model performances were evaluated by comparing them with ground observations and the spatial prediction errors. KED and data fusion performed better at monitoring sites with a daily model R 2 of 0.95 and 0.94, respectively and PM 2.5 was overestimated by WRF-Chem (R 2 =0.51). KED and data fusion performed better around the ground monitors, WRF-Chem performed relative worse with high prediction errors in the central of study domain. In our study, both KED and data fusion technique provided highly accurate PM 2.5 . Current monitoring network in North China was dense enough to provide a reliable PM 2.5 prediction by interpolation technique. Copyright © 2017. Published by Elsevier Inc.

Fusion of imaging and nonimaging data for surveillance aircraft

NASA Astrophysics Data System (ADS)

Shahbazian, Elisa; Gagnon, Langis; Duquet, Jean Remi; Macieszczak, Maciej; Valin, Pierre

1997-06-01

This paper describes a phased incremental integration approach for application of image analysis and data fusion technologies to provide automated intelligent target tracking and identification for airborne surveillance on board an Aurora Maritime Patrol Aircraft. The sensor suite of the Aurora consists of a radar, an identification friend or foe (IFF) system, an electronic support measures (ESM) system, a spotlight synthetic aperture radar (SSAR), a forward looking infra-red (FLIR) sensor and a link-11 tactical datalink system. Lockheed Martin Canada (LMCan) is developing a testbed, which will be used to analyze and evaluate approaches for combining the data provided by the existing sensors, which were initially not designed to feed a fusion system. Three concurrent research proof-of-concept activities provide techniques, algorithms and methodology into three sequential phases of integration of this testbed. These activities are: (1) analysis of the fusion architecture (track/contact/hybrid) most appropriate for the type of data available, (2) extraction and fusion of simple features from the imaging data into the fusion system performing automatic target identification, and (3) development of a unique software architecture which will permit integration and independent evolution, enhancement and optimization of various decision aid capabilities, such as multi-sensor data fusion (MSDF), situation and threat assessment (STA) and resource management (RM).

Radiation and Electromagnetic Induction Data Fusion for Detection of Buried Radioactive Metal Waste - 12282

DOE Office of Scientific and Technical Information (OSTI.GOV)

Long, Zhiling; Wei, Wei; Turlapaty, Anish

2012-07-01

At the United States Army's test sites, fired penetrators made of Depleted Uranium (DU) have been buried under ground and become hazardous waste. Previously, we developed techniques for detecting buried radioactive targets. We also developed approaches for locating buried paramagnetic metal objects by utilizing the electromagnetic induction (EMI) sensor data. In this paper, we apply data fusion techniques to combine results from both the radiation detection and the EMI detection, so that we can further distinguish among DU penetrators, DU oxide, and non- DU metal debris. We develop a two-step fusion approach for the task, and test it with surveymore » data collected on simulation targets. In this work, we explored radiation and EMI data fusion for detecting DU, oxides, and non-DU metals. We developed a two-step fusion approach based on majority voting and a set of decision rules. With this approach, we fuse results from radiation detection based on the RX algorithm and EMI detection based on a 3-step analysis. Our fusion approach has been tested successfully with data collected on simulation targets. In the future, we will need to further verify the effectiveness of this fusion approach with field data. (authors)« less

Molecular Diagnostics of Fusion and Laboratory Plasmas

NASA Astrophysics Data System (ADS)

Fantz, U.

2005-05-01

The presence of molecules in the cold scrape-off layer of fusion experiments and industrial plasmas requires an understanding of the molecular dynamics in these low temperature plasmas. Suitable diagnostic methods can provide an insight in molecular processes in the plasma volume as well as for plasma surface interactions. A very simple but powerful technique is the molecular emission spectroscopy. Spectra are obtained easily, whereas interpretation might be very complex and relies on the availability of atomic and molecular data. Examples are given for hydrogen plasmas and plasmas with hydrocarbons which both are of importance in industrial applications as well as in fusion experiments.

Data fusion for CD metrology: heterogeneous hybridization of scatterometry, CDSEM, and AFM data

NASA Astrophysics Data System (ADS)

Hazart, J.; Chesneau, N.; Evin, G.; Largent, A.; Derville, A.; Thérèse, R.; Bos, S.; Bouyssou, R.; Dezauzier, C.; Foucher, J.

2014-04-01

The manufacturing of next generation semiconductor devices forces metrology tool providers for an exceptional effort in order to meet the requirements for precision, accuracy and throughput stated in the ITRS. In the past years hybrid metrology (based on data fusion theories) has been investigated as a new methodology for advanced metrology [1][2][3]. This paper provides a new point of view of data fusion for metrology through some experiments and simulations. The techniques are presented concretely in terms of equations to be solved. The first point of view is High Level Fusion which is the use of simple numbers with their associated uncertainty postprocessed by tools. In this paper, it is divided into two stages: one for calibration to reach accuracy, the second to reach precision thanks to Bayesian Fusion. From our perspective, the first stage is mandatory before applying the second stage which is commonly presented [1]. However a reference metrology system is necessary for this fusion. So, precision can be improved if and only if the tools to be fused are perfectly matched at least for some parameters. We provide a methodology similar to a multidimensional TMU able to perform this matching exercise. It is demonstrated on a 28 nm node backend lithography case. The second point of view is Deep Level Fusion which works on the contrary with raw data and their combination. In the approach presented here, the analysis of each raw data is based on a parametric model and connections between the parameters of each tool. In order to allow OCD/SEM Deep Level Fusion, a SEM Compact Model derived from [4] has been developed and compared to AFM. As far as we know, this is the first time such techniques have been coupled at Deep Level. A numerical study on the case of a simple stack for lithography is performed. We show strict equivalence of Deep Level Fusion and High Level Fusion when tools are sensitive and models are perfect. When one of the tools can be considered as a

Benchmarking of data fusion algorithms in support of earth observation based Antarctic wildlife monitoring

NASA Astrophysics Data System (ADS)

Witharana, Chandi; LaRue, Michelle A.; Lynch, Heather J.

2016-03-01

Remote sensing is a rapidly developing tool for mapping the abundance and distribution of Antarctic wildlife. While both panchromatic and multispectral imagery have been used in this context, image fusion techniques have received little attention. We tasked seven widely-used fusion algorithms: Ehlers fusion, hyperspherical color space fusion, high-pass fusion, principal component analysis (PCA) fusion, University of New Brunswick fusion, and wavelet-PCA fusion to resolution enhance a series of single-date QuickBird-2 and Worldview-2 image scenes comprising penguin guano, seals, and vegetation. Fused images were assessed for spectral and spatial fidelity using a variety of quantitative quality indicators and visual inspection methods. Our visual evaluation elected the high-pass fusion algorithm and the University of New Brunswick fusion algorithm as best for manual wildlife detection while the quantitative assessment suggested the Gram-Schmidt fusion algorithm and the University of New Brunswick fusion algorithm as best for automated classification. The hyperspherical color space fusion algorithm exhibited mediocre results in terms of spectral and spatial fidelities. The PCA fusion algorithm showed spatial superiority at the expense of spectral inconsistencies. The Ehlers fusion algorithm and the wavelet-PCA algorithm showed the weakest performances. As remote sensing becomes a more routine method of surveying Antarctic wildlife, these benchmarks will provide guidance for image fusion and pave the way for more standardized products for specific types of wildlife surveys.

Recent Advances in Registration, Integration and Fusion of Remotely Sensed Data: Redundant Representations and Frames

NASA Technical Reports Server (NTRS)

Czaja, Wojciech; Le Moigne-Stewart, Jacqueline

2014-01-01

In recent years, sophisticated mathematical techniques have been successfully applied to the field of remote sensing to produce significant advances in applications such as registration, integration and fusion of remotely sensed data. Registration, integration and fusion of multiple source imagery are the most important issues when dealing with Earth Science remote sensing data where information from multiple sensors, exhibiting various resolutions, must be integrated. Issues ranging from different sensor geometries, different spectral responses, differing illumination conditions, different seasons, and various amounts of noise need to be dealt with when designing an image registration, integration or fusion method. This tutorial will first define the problems and challenges associated with these applications and then will review some mathematical techniques that have been successfully utilized to solve them. In particular, we will cover topics on geometric multiscale representations, redundant representations and fusion frames, graph operators, diffusion wavelets, as well as spatial-spectral and operator-based data fusion. All the algorithms will be illustrated using remotely sensed data, with an emphasis on current and operational instruments.

Circumferential Fusion through All-Posterior Approach in Andersson Lesion.

PubMed

Rajoli, Sreekanth Reddy; Kanna, Rishi Mugesh; Aiyer, Siddharth N; Shetty, Ajoy Prasad; Rajasekaran, Shanmuganathan

2017-06-01

Retrospective case series. To assess safety and efficacy of single stage, posterior stabilisation and anterior cage reconstruction through the transforaminal or lateral extra-cavitary route for Andersson lesions. Pseudoarthrosis in ankylosing spondylitis (Andersson lesion, AL) can cause progressive kyphosis and neurological deficit. Management involves early recognition and surgical stabilisation in patients with instability. However, the need and safety of anterior reconstruction of the vertebral body defect remains unclear. Twenty consecutive patients with AL whom presented with instability back pain and or neurological deficit were managed by single stage posterior approach with long segment pedicle screw fixation and anterior vertebral reconstruction. Radiological evaluation included- the regional kyphotic angle, measurement of anterior defect in computed tomography (CT) scan and the spinal cord status in magnetic resonance imaging. Radiological outcomes were assessed for fusion and kyphosis correction. Functional outcomes were assessed with visual analogue scale (VAS), ankylosing spondylitis quality of life (ASQoL) and Oswestry disability index (ODI). The mean age of the patients was 50.1 years (male, 18; female, 2). The levels affected include thoracolumbar (n=12), lower thoracic (n=5) and lumbar (n=3) regions. The mean level of fixation was 6.2±2.4 vertebrae. The mean anterior column defect was 1.6±0.6 cm. The mean surgical duration, blood loss and hospital stay were 112 minutes, 452 mL and 6.2 days, respectively. The mean followup was 2.1 years. At final follow up, VAS for back pain improved from 8.2 to 2.4 while ODI improved from 62.7 to 18.5 ( p <0.05) and ASQoL improved from 14.3±2.08 to 7.90±1.48 ( p <0.05). All patients had achieved radiological union at a mean 7.2±4.6 months. The mean regional kyphotic angle was 27° preoperatively, 16.7° postoperatively and 18.1° at the final follow-up. Posterior stabilisation and anterior reconstruction with

Embedding the results of focussed Bayesian fusion into a global context

NASA Astrophysics Data System (ADS)

Sander, Jennifer; Heizmann, Michael

2014-05-01

Bayesian statistics offers a well-founded and powerful fusion methodology also for the fusion of heterogeneous information sources. However, except in special cases, the needed posterior distribution is not analytically derivable. As consequence, Bayesian fusion may cause unacceptably high computational and storage costs in practice. Local Bayesian fusion approaches aim at reducing the complexity of the Bayesian fusion methodology significantly. This is done by concentrating the actual Bayesian fusion on the potentially most task relevant parts of the domain of the Properties of Interest. Our research on these approaches is motivated by an analogy to criminal investigations where criminalists pursue clues also only locally. This publication follows previous publications on a special local Bayesian fusion technique called focussed Bayesian fusion. Here, the actual calculation of the posterior distribution gets completely restricted to a suitably chosen local context. By this, the global posterior distribution is not completely determined. Strategies for using the results of a focussed Bayesian analysis appropriately are needed. In this publication, we primarily contrast different ways of embedding the results of focussed Bayesian fusion explicitly into a global context. To obtain a unique global posterior distribution, we analyze the application of the Maximum Entropy Principle that has been shown to be successfully applicable in metrology and in different other areas. To address the special need for making further decisions subsequently to the actual fusion task, we further analyze criteria for decision making under partial information.

Affordable non-traditional source data mining for context assessment to improve distributed fusion system robustness

NASA Astrophysics Data System (ADS)

Bowman, Christopher; Haith, Gary; Steinberg, Alan; Morefield, Charles; Morefield, Michael

2013-05-01

This paper describes methods to affordably improve the robustness of distributed fusion systems by opportunistically leveraging non-traditional data sources. Adaptive methods help find relevant data, create models, and characterize the model quality. These methods also can measure the conformity of this non-traditional data with fusion system products including situation modeling and mission impact prediction. Non-traditional data can improve the quantity, quality, availability, timeliness, and diversity of the baseline fusion system sources and therefore can improve prediction and estimation accuracy and robustness at all levels of fusion. Techniques are described that automatically learn to characterize and search non-traditional contextual data to enable operators integrate the data with the high-level fusion systems and ontologies. These techniques apply the extension of the Data Fusion & Resource Management Dual Node Network (DNN) technical architecture at Level 4. The DNN architecture supports effectively assessment and management of the expanded portfolio of data sources, entities of interest, models, and algorithms including data pattern discovery and context conformity. Affordable model-driven and data-driven data mining methods to discover unknown models from non-traditional and `big data' sources are used to automatically learn entity behaviors and correlations with fusion products, [14 and 15]. This paper describes our context assessment software development, and the demonstration of context assessment of non-traditional data to compare to an intelligence surveillance and reconnaissance fusion product based upon an IED POIs workflow.

Infrared and visible image fusion with spectral graph wavelet transform.

PubMed

Yan, Xiang; Qin, Hanlin; Li, Jia; Zhou, Huixin; Zong, Jing-guo

2015-09-01

Infrared and visible image fusion technique is a popular topic in image analysis because it can integrate complementary information and obtain reliable and accurate description of scenes. Multiscale transform theory as a signal representation method is widely used in image fusion. In this paper, a novel infrared and visible image fusion method is proposed based on spectral graph wavelet transform (SGWT) and bilateral filter. The main novelty of this study is that SGWT is used for image fusion. On the one hand, source images are decomposed by SGWT in its transform domain. The proposed approach not only effectively preserves the details of different source images, but also excellently represents the irregular areas of the source images. On the other hand, a novel weighted average method based on bilateral filter is proposed to fuse low- and high-frequency subbands by taking advantage of spatial consistency of natural images. Experimental results demonstrate that the proposed method outperforms seven recently proposed image fusion methods in terms of both visual effect and objective evaluation metrics.

Adaptive multifocus image fusion using block compressed sensing with smoothed projected Landweber integration in the wavelet domain.

PubMed

V S, Unni; Mishra, Deepak; Subrahmanyam, G R K S

2016-12-01

The need for image fusion in current image processing systems is increasing mainly due to the increased number and variety of image acquisition techniques. Image fusion is the process of combining substantial information from several sensors using mathematical techniques in order to create a single composite image that will be more comprehensive and thus more useful for a human operator or other computer vision tasks. This paper presents a new approach to multifocus image fusion based on sparse signal representation. Block-based compressive sensing integrated with a projection-driven compressive sensing (CS) recovery that encourages sparsity in the wavelet domain is used as a method to get the focused image from a set of out-of-focus images. Compression is achieved during the image acquisition process using a block compressive sensing method. An adaptive thresholding technique within the smoothed projected Landweber recovery process reconstructs high-resolution focused images from low-dimensional CS measurements of out-of-focus images. Discrete wavelet transform and dual-tree complex wavelet transform are used as the sparsifying basis for the proposed fusion. The main finding lies in the fact that sparsification enables a better selection of the fusion coefficients and hence better fusion. A Laplacian mixture model fit is done in the wavelet domain and estimation of the probability density function (pdf) parameters by expectation maximization leads us to the proper selection of the coefficients of the fused image. Using the proposed method compared with the fusion scheme without employing the projected Landweber (PL) scheme and the other existing CS-based fusion approaches, it is observed that with fewer samples itself, the proposed method outperforms other approaches.

Bringing functions together with fusion enzymes--from nature's inventions to biotechnological applications.

PubMed

Elleuche, Skander

2015-02-01

It is a mammoth task to develop a modular protein toolbox enabling the production of posttranslational organized multifunctional enzymes that catalyze reactions in complex pathways. However, nature has always guided scientists to mimic evolutionary inventions in the laboratory and, nowadays, versatile methods have been established to experimentally connect enzymatic activities with multiple advantages. Among the oldest known natural examples is the linkage of two or more juxtaposed proteins catalyzing consecutive, non-consecutive, or opposing reactions by a native peptide bond. There are multiple reasons for the artificial construction of such fusion enzymes including improved catalytic activities, enabled substrate channelling by proximity of biocatalysts, higher stabilities, and cheaper production processes. To produce fused proteins, it is either possible to genetically fuse coding open reading frames or to connect proteins in a posttranslational process. Molecular biology techniques that have been established for the production of end-to-end or insertional fusions include overlap extension polymerase chain reaction, cloning, and recombination approaches. Depending on their flexibility and applicability, these methods offer various advantages to produce fusion genes in high throughput, different orientations, and including linker sequences to maximize the flexibility and performance of fusion partners. In this review, practical techniques to fuse genes are highlighted, enzymatic parameters to choose adequate enzymes for fusion approaches are summarized, and examples with biotechnological relevance are presented including a focus on plant biomass-degrading glycosyl hydrolases.

A Matrix Pencil Algorithm Based Multiband Iterative Fusion Imaging Method

NASA Astrophysics Data System (ADS)

Zou, Yong Qiang; Gao, Xun Zhang; Li, Xiang; Liu, Yong Xiang

2016-01-01

Multiband signal fusion technique is a practicable and efficient way to improve the range resolution of ISAR image. The classical fusion method estimates the poles of each subband signal by the root-MUSIC method, and some good results were get in several experiments. However, this method is fragile in noise for the proper poles could not easy to get in low signal to noise ratio (SNR). In order to eliminate the influence of noise, this paper propose a matrix pencil algorithm based method to estimate the multiband signal poles. And to deal with mutual incoherent between subband signals, the incoherent parameters (ICP) are predicted through the relation of corresponding poles of each subband. Then, an iterative algorithm which aimed to minimize the 2-norm of signal difference is introduced to reduce signal fusion error. Applications to simulate dada verify that the proposed method get better fusion results at low SNR.

Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion

PubMed Central

Ledonio, Charles GT; Polly, David W; Swiontkowski, Marc F; Cummings, John T

2014-01-01

Background The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS) surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI) outcomes associated with each of these techniques. Methods A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher’s exact test and two nonparametric tests, ie, the Mann–Whitney U test and the Wilcoxon signed-rank test. The results are presented as percent or median with range, as appropriate. Results Forty-nine patients from two institutions underwent sacroiliac joint fusion between 2006 and 2012. Ten patients were excluded because of incomplete data, leaving 39 evaluable patients, of whom 22 underwent open and 17 underwent MIS sacroiliac joint fusion. The MIS group was significantly older (median age 66 [39–82] years) than the open group (median age 51 [34–74] years). Surgical time and hospital stay were significantly shorter in the MIS group than in the open group. Preoperative ODI was significantly greater in the open group (median 64 [44–78]) than in the MIS group (median 53 [14–84]). Postoperative improvement in ODI was statistically significant within and between groups, with MIS resulting in greater improvement. Conclusion The open and MIS sacroiliac joint fusion techniques resulted in statistically and clinically significant improvement for patients with degenerative sacroiliitis refractory to nonoperative

Is minimal access spine surgery more cost-effective than conventional spine surgery?

PubMed

Lubelski, Daniel; Mihalovich, Kathryn E; Skelly, Andrea C; Fehlings, Michael G; Harrop, James S; Mummaneni, Praveen V; Wang, Michael Y; Steinmetz, Michael P

2014-10-15

Systematic review. To summarize and critically review the economic literature evaluating the cost-effectiveness of minimal access surgery (MAS) compared with conventional open procedures for the cervical and lumbar spine. MAS techniques may improve perioperative parameters (length of hospital stay and extent of blood loss) compared with conventional open approaches. However, some have questioned the clinical efficacy of these differences and the associated cost-effectiveness implications. When considering the long-term outcomes, there seem to be no significant differences between MAS and open surgery. PubMed, EMBASE, the Cochrane Collaboration database, University of York, Centre for Reviews and Dissemination (NHS-EED and HTA), and the Tufts CEA Registry were reviewed to identify full economic studies comparing MAS with open techniques prior to December 24, 2013, based on the key questions established a priori. Only economic studies that evaluated and synthesized the costs and consequences of MAS compared with conventional open procedures (i.e., cost-minimization, cost-benefit, cost-effectiveness, or cost-utility) were considered for inclusion. Full text of the articles meeting inclusion criteria were reviewed by 2 independent investigators to obtain the final collection of included studies. The Quality of Health Economic Studies instrument was scored by 2 independent reviewers to provide an initial basis for critical appraisal of included economic studies. The search strategy yielded 198 potentially relevant citations, and 6 studies met the inclusion criteria, evaluating the costs and consequences of MAS versus conventional open procedures performed for the lumbar spine; no studies for the cervical spine met the inclusion criteria. Studies compared MAS tubular discectomy with conventional microdiscectomy, minimal access transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion, and multilevel hemilaminectomy via MAS versus open

Label fusion based brain MR image segmentation via a latent selective model

NASA Astrophysics Data System (ADS)

Liu, Gang; Guo, Xiantang; Zhu, Kai; Liao, Hengxu

2018-04-01

Multi-atlas segmentation is an effective approach and increasingly popular for automatically labeling objects of interest in medical images. Recently, segmentation methods based on generative models and patch-based techniques have become the two principal branches of label fusion. However, these generative models and patch-based techniques are only loosely related, and the requirement for higher accuracy, faster segmentation, and robustness is always a great challenge. In this paper, we propose novel algorithm that combines the two branches using global weighted fusion strategy based on a patch latent selective model to perform segmentation of specific anatomical structures for human brain magnetic resonance (MR) images. In establishing this probabilistic model of label fusion between the target patch and patch dictionary, we explored the Kronecker delta function in the label prior, which is more suitable than other models, and designed a latent selective model as a membership prior to determine from which training patch the intensity and label of the target patch are generated at each spatial location. Because the image background is an equally important factor for segmentation, it is analyzed in label fusion procedure and we regard it as an isolated label to keep the same privilege between the background and the regions of interest. During label fusion with the global weighted fusion scheme, we use Bayesian inference and expectation maximization algorithm to estimate the labels of the target scan to produce the segmentation map. Experimental results indicate that the proposed algorithm is more accurate and robust than the other segmentation methods.

Axial presacral lumbar interbody fusion and percutaneous posterior fixation for stabilization of lumbosacral isthmic spondylolisthesis.

PubMed

Gerszten, Peter C; Tobler, William; Raley, Thomas J; Miller, Larry E; Block, Jon E; Nasca, Richard J

2012-04-01

Case series. To describe a minimally invasive surgical technique for treatment of lumbosacral spondylolisthesis. Traditional surgical management of lumbosacral spondylolisthesis is technically challenging and associated with significant complications. Minimally invasive surgical techniques offer patients treatment alternatives with lower operative morbidity risk. The combination of percutaneous pedicle screw reduction and an axial presacral approach for lumbosacral discectomy and fusion is an option for the surgical management of low-grade lumbosacral spondylolisthesis. Twenty-six consecutive patients with symptomatic L5-S1 level isthmic spondylolisthesis (grade 1 or grade 2) underwent axial presacral lumbar interbody fusion and percutaneous posterior fixation. Study outcomes included visual analogue scale for axial pain severity, Odom criteria, and radiographic fusion. The procedure was successfully completed in all patients with no intraoperative complications reported. Intraoperative blood loss was minimal (range, 20-150 mL). Median hospital stay was 1 day (range, <1-2 d). Spondylolisthesis grade was improved after axial lumbar interbody fusion (P<0.001) with 50% (13 of 26) of patients showing a reduction of at least 1 grade. Axial pain severity improved from 8.1±1.4 at baseline to 2.8±2.3 after axial lumbar interbody fusion, representing a 66% reduction from baseline (95% confidence interval, 54.3%-77.9%). At 2-year posttreatment, all patients showed solid fusion. Using Odom criteria, 81% of patients were judged as excellent or good (16 excellent, 5 good, 3 fair, and 2 poor). There were no perioperative procedure-related complications including infection or bowel perforation. During postoperative follow-up, 4 patients required reintervention due to recurrent radicular (n=2) or screw-related (n=2) pain. The minimally invasive presacral axial interbody fusion and posterior instrumentation technique is a safe and effective treatment for low-grade isthmic

Hyperspectral face recognition with spatiospectral information fusion and PLS regression.

PubMed

Uzair, Muhammad; Mahmood, Arif; Mian, Ajmal

2015-03-01

Hyperspectral imaging offers new opportunities for face recognition via improved discrimination along the spectral dimension. However, it poses new challenges, including low signal-to-noise ratio, interband misalignment, and high data dimensionality. Due to these challenges, the literature on hyperspectral face recognition is not only sparse but is limited to ad hoc dimensionality reduction techniques and lacks comprehensive evaluation. We propose a hyperspectral face recognition algorithm using a spatiospectral covariance for band fusion and partial least square regression for classification. Moreover, we extend 13 existing face recognition techniques, for the first time, to perform hyperspectral face recognition.We formulate hyperspectral face recognition as an image-set classification problem and evaluate the performance of seven state-of-the-art image-set classification techniques. We also test six state-of-the-art grayscale and RGB (color) face recognition algorithms after applying fusion techniques on hyperspectral images. Comparison with the 13 extended and five existing hyperspectral face recognition techniques on three standard data sets show that the proposed algorithm outperforms all by a significant margin. Finally, we perform band selection experiments to find the most discriminative bands in the visible and near infrared response spectrum.

FT-MIR and NIR spectral data fusion: a synergetic strategy for the geographical traceability of Panax notoginseng.

PubMed

Li, Yun; Zhang, Jin-Yu; Wang, Yuan-Zhong

2018-01-01

Three data fusion strategies (low-llevel, mid-llevel, and high-llevel) combined with a multivariate classification algorithm (random forest, RF) were applied to authenticate the geographical origins of Panax notoginseng collected from five regions of Yunnan province in China. In low-level fusion, the original data from two spectra (Fourier transform mid-IR spectrum and near-IR spectrum) were directly concatenated into a new matrix, which then was applied for the classification. Mid-level fusion was the strategy that inputted variables extracted from the spectral data into an RF classification model. The extracted variables were processed by iterate variable selection of the RF model and principal component analysis. The use of high-level fusion combined the decision making of each spectroscopic technique and resulted in an ensemble decision. The results showed that the mid-level and high-level data fusion take advantage of the information synergy from two spectroscopic techniques and had better classification performance than that of independent decision making. High-level data fusion is the most effective strategy since the classification results are better than those of the other fusion strategies: accuracy rates ranged between 93% and 96% for the low-level data fusion, between 95% and 98% for the mid-level data fusion, and between 98% and 100% for the high-level data fusion. In conclusion, the high-level data fusion strategy for Fourier transform mid-IR and near-IR spectra can be used as a reliable tool for correct geographical identification of P. notoginseng. Graphical abstract The analytical steps of Fourier transform mid-IR and near-IR spectral data fusion for the geographical traceability of Panax notoginseng.

Fusion of monocular cues to detect man-made structures in aerial imagery

NASA Technical Reports Server (NTRS)

Shufelt, Jefferey; Mckeown, David M.

1991-01-01

The extraction of buildings from aerial imagery is a complex problem for automated computer vision. It requires locating regions in a scene that possess properties distinguishing them as man-made objects as opposed to naturally occurring terrain features. It is reasonable to assume that no single detection method can correctly delineate or verify buildings in every scene. A cooperative-methods paradigm is useful in approaching the building extraction problem. Using this paradigm, each extraction technique provides information which can be added or assimilated into an overall interpretation of the scene. Thus, the main objective is to explore the development of computer vision system that integrates the results of various scene analysis techniques into an accurate and robust interpretation of the underlying three dimensional scene. The problem of building hypothesis fusion in aerial imagery is discussed. Building extraction techniques are briefly surveyed, including four building extraction, verification, and clustering systems. A method for fusing the symbolic data generated by these systems is described, and applied to monocular image and stereo image data sets. Evaluation methods for the fusion results are described, and the fusion results are analyzed using these methods.

Rho GTPase activity modulates paramyxovirus fusion protein-mediated cell-cell fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schowalter, Rachel M.; Wurth, Mark A.; Aguilar, Hector C.

2006-07-05

The paramyxovirus fusion protein (F) promotes fusion of the viral envelope with the plasma membrane of target cells as well as cell-cell fusion. The plasma membrane is closely associated with the actin cytoskeleton, but the role of actin dynamics in paramyxovirus F-mediated membrane fusion is unclear. We examined cell-cell fusion promoted by two different paramyxovirus F proteins in three cell types in the presence of constitutively active Rho family GTPases, major cellular coordinators of actin dynamics. Reporter gene and syncytia assays demonstrated that expression of either Rac1{sup V12} or Cdc42{sup V12} could increase cell-cell fusion promoted by the Hendra ormore » SV5 glycoproteins, though the effect was dependent on the cell type expressing the viral glycoproteins. In contrast, RhoA{sup L63} decreased cell-cell fusion promoted by Hendra glycoproteins but had little affect on SV5 F-mediated fusion. Also, data suggested that GTPase activation in the viral glycoprotein-containing cell was primarily responsible for changes in fusion. Additionally, we found that activated Cdc42 promoted nuclear rearrangement in syncytia.« less

Knee arthrodesis using a short locked intramedullary nail. A new technique.

PubMed

Cheng, S L; Gross, A E

1995-01-01

This article reports on the use of a new intramedullary nail designed specifically for fixation of knee fusions. The nail is a short locked stainless steel nail that is inserted through a single anterior knee incision and uses an outrigger targeting rod to guide the insertion of the locking screws. The successful use of this technique is illustrated in two cases. The advantages of this nail compared with previously reported techniques of fixation for knee fusions are that the short locked nail avoids the second incision required for the insertion of long knee fusion nails, the bulkiness of the double plating technique in the relatively subcutaneous anterior knee area, and the difficulties inherent with the prolonged use of pins for external fixation.

Continuous internal channels formed in aluminum fusion welds

NASA Technical Reports Server (NTRS)

Gault, J.; Sabo, W.

1967-01-01

Process produces continuous internal channel systems on a repeatable basis in 2014-T6 aluminum. Standard machining forms the initial channel, which is filled with tungsten carbide powder. TIG machine fusion welding completes formation of the channel. Chem-mill techniques enlarge it to the desired size.

The Fusion Gain Analysis of the Inductively Driven Liner Compression Based Fusion

NASA Astrophysics Data System (ADS)

Shimazu, Akihisa; Slough, John

2016-10-01

An analytical analysis of the fusion gain expected in the inductively driven liner compression (IDLC) based fusion is conducted to identify the fusion gain scaling at various operating conditions. The fusion based on the IDLC is a magneto-inertial fusion concept, where a Field-Reversed Configuration (FRC) plasmoid is compressed via the inductively-driven metal liner to drive the FRC to fusion conditions. In the past, an approximate scaling law for the expected fusion gain for the IDLC based fusion was obtained under the key assumptions of (1) D-T fuel at 5-40 keV, (2) adiabatic scaling laws for the FRC dynamics, (3) FRC energy dominated by the pressure balance with the edge magnetic field at the peak compression, and (4) the liner dwell time being liner final diameter divided by the peak liner velocity. In this study, various assumptions made in the previous derivation is relaxed to study the change in the fusion gain scaling from the previous result of G ml1 / 2 El11 / 8 , where ml is the liner mass and El is the peak liner kinetic energy. The implication from the modified fusion gain scaling on the performance of the IDLC fusion reactor system is also explored.

A measurement fusion method for nonlinear system identification using a cooperative learning algorithm.

PubMed

Xia, Youshen; Kamel, Mohamed S

2007-06-01

Identification of a general nonlinear noisy system viewed as an estimation of a predictor function is studied in this article. A measurement fusion method for the predictor function estimate is proposed. In the proposed scheme, observed data are first fused by using an optimal fusion technique, and then the optimal fused data are incorporated in a nonlinear function estimator based on a robust least squares support vector machine (LS-SVM). A cooperative learning algorithm is proposed to implement the proposed measurement fusion method. Compared with related identification methods, the proposed method can minimize both the approximation error and the noise error. The performance analysis shows that the proposed optimal measurement fusion function estimate has a smaller mean square error than the LS-SVM function estimate. Moreover, the proposed cooperative learning algorithm can converge globally to the optimal measurement fusion function estimate. Finally, the proposed measurement fusion method is applied to ARMA signal and spatial temporal signal modeling. Experimental results show that the proposed measurement fusion method can provide a more accurate model.

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.

Facility Monitoring: A Qualitative Theory for Sensor Fusion

NASA Technical Reports Server (NTRS)

Figueroa, Fernando

2001-01-01

Data fusion and sensor management approaches have largely been implemented with centralized and hierarchical architectures. Numerical and statistical methods are the most common data fusion methods found in these systems. Given the proliferation and low cost of processing power, there is now an emphasis on designing distributed and decentralized systems. These systems use analytical/quantitative techniques or qualitative reasoning methods for date fusion.Based on other work by the author, a sensor may be treated as a highly autonomous (decentralized) unit. Each highly autonomous sensor (HAS) is capable of extracting qualitative behaviours from its data. For example, it detects spikes, disturbances, noise levels, off-limit excursions, step changes, drift, and other typical measured trends. In this context, this paper describes a distributed sensor fusion paradigm and theory where each sensor in the system is a HAS. Hence, given the reach qualitative information from each HAS, a paradigm and formal definitions are given so that sensors and processes can reason and make decisions at the qualitative level. This approach to sensor fusion makes it possible the implementation of intuitive (effective) methods to monitor, diagnose, and compensate processes/systems and their sensors. This paradigm facilitates a balanced distribution of intelligence (code and/or hardware) to the sensor level, the process/system level, and a higher controller level. The primary application of interest is in intelligent health management of rocket engine test stands.

Advances in Multi-Sensor Information Fusion: Theory and Applications 2017.

PubMed

Jin, Xue-Bo; Sun, Shuli; Wei, Hong; Yang, Feng-Bao

2018-04-11

The information fusion technique can integrate a large amount of data and knowledge representing the same real-world object and obtain a consistent, accurate, and useful representation of that object. The data may be independent or redundant, and can be obtained by different sensors at the same time or at different times. A suitable combination of investigative methods can substantially increase the profit of information in comparison with that from a single sensor. Multi-sensor information fusion has been a key issue in sensor research since the 1970s, and it has been applied in many fields. For example, manufacturing and process control industries can generate a lot of data, which have real, actionable business value. The fusion of these data can greatly improve productivity through digitization. The goal of this special issue is to report innovative ideas and solutions for multi-sensor information fusion in the emerging applications era, focusing on development, adoption, and applications.

A Matrix Pencil Algorithm Based Multiband Iterative Fusion Imaging Method

PubMed Central

Zou, Yong Qiang; Gao, Xun Zhang; Li, Xiang; Liu, Yong Xiang

2016-01-01

Multiband signal fusion technique is a practicable and efficient way to improve the range resolution of ISAR image. The classical fusion method estimates the poles of each subband signal by the root-MUSIC method, and some good results were get in several experiments. However, this method is fragile in noise for the proper poles could not easy to get in low signal to noise ratio (SNR). In order to eliminate the influence of noise, this paper propose a matrix pencil algorithm based method to estimate the multiband signal poles. And to deal with mutual incoherent between subband signals, the incoherent parameters (ICP) are predicted through the relation of corresponding poles of each subband. Then, an iterative algorithm which aimed to minimize the 2-norm of signal difference is introduced to reduce signal fusion error. Applications to simulate dada verify that the proposed method get better fusion results at low SNR. PMID:26781194

From Data Acquisition to Data Fusion: A Comprehensive Review and a Roadmap for the Identification of Activities of Daily Living Using Mobile Devices

PubMed Central

Pires, Ivan Miguel; Garcia, Nuno M.; Pombo, Nuno; Flórez-Revuelta, Francisco

2016-01-01

This paper focuses on the research on the state of the art for sensor fusion techniques, applied to the sensors embedded in mobile devices, as a means to help identify the mobile device user’s daily activities. Sensor data fusion techniques are used to consolidate the data collected from several sensors, increasing the reliability of the algorithms for the identification of the different activities. However, mobile devices have several constraints, e.g., low memory, low battery life and low processing power, and some data fusion techniques are not suited to this scenario. The main purpose of this paper is to present an overview of the state of the art to identify examples of sensor data fusion techniques that can be applied to the sensors available in mobile devices aiming to identify activities of daily living (ADLs). PMID:26848664

Investigation of fusion reactions in palladium and titanium tritide using galvanostatic, coulometric, and hydrogen permeation techniques

NASA Astrophysics Data System (ADS)

Guilinger, T. R.; Kelly, M. J.; Scully, J. R.; Christensen, T. M.; Ingersoll, D.; Knapp, J. A.; Ewing, R. I.; Casey, W. H.; Tsao, S. S.

1990-09-01

We describe several electrochemical methods used to investigate the possibility of cold fusion phenomena in palladium and titanium tritide cathodes. We performed long-term (up to 77 days) electrolysis experiments with electrochemical cells of the University of Utah type at current densities as high as 1 A/cm2, while monitoring neutron and tritium levels. With some cells, we pulsed the current to determine if neutron bursts would result. In another cell, we used titanium tritide as the cathode to determine if D-T reactions yielding neutrons would occur. In no instance were levels of neutrons or tritium significantly above background except in the titanium tritide cell where isotopic exchange, occcurring between the electrode and the electrolyte, resulted in significant tritium levels. We also combined x-ray photoelectron spectroscopy (XPS) and electrochemical hydrogen permeation experiments to determine the effectiveness of various Pd surface treatment procedures on the resultant electrochemical hydrogen absorption efficiency. Electroanalytical and thermal desorption/gas analysis techniques indicated the maximum loading of H in Pd was to a ratio of H∶Pd=0.8.

The application of microwave digestion in decomposing some refractory ore samples with solid fusion agent.

PubMed

Lu, Yan; Li, Gang; Liu, Wei; Yuan, Hongyan; Xiao, Dan

2018-08-15

It is known that most of the refractory ore are the basis of national economy and widely applied in various fields, however, the complexity of the chemical composition and the diversity of the crystallinity in the mineral phases make the sample pre-treatment of refractory ore still remains a challenge. In this work, the complete decomposition of the refractory ore sample can be achieved just by exposing the solid fusion agent and the refractory ore sample in the microwave irradiation environment for a few minutes, and induced by a drop of water. A digestion time of 15 min for 3.0 g solid fusion agent mixture of sodium peroxide/sodium carbonate (Na 2 O 2 /Na 2 CO 3 ) in a corundum crucible via microwave heating is sufficient to decompose 0.1 g refractory ore sample. An excellent microwave digestion solid agent should meet the following conditions, a good decomposition ability, an outstanding ability of absorbing microwave energy and converting it into heat quickly, a higher melting point than the decomposing temperature of the ore sample. In the research, the induction effect of water plays an important role for the microwave digestion. The energy which is released by the reaction of water and the solid fusion agent (Na 2 O 2 ) is the key to decompose refractory ore samples with solid fusion agent, which replenished the total energy required for the microwave digestion and made the microwave digestion completed successfully. This microwave digestion technique has good reproducibility and precision, RSD % for Mo, Fe, Ti, Cr and W in the refractory ore samples were all better than 6, except RSD % for Be of about 8 because of the influence of matrix-effect. Meanwhile, the analysis results of the elements in the refractory ore samples provided by the microwave digestion technique were all in good agreement with the analysis results provided by the traditional fusion method except for Cr in the mixture ore samples. In the study, the non-linear dependence of the

Image Fusion During Vascular and Nonvascular Image-Guided Procedures☆

PubMed Central

Abi-Jaoudeh, Nadine; Kobeiter, Hicham; Xu, Sheng; Wood, Bradford J.

2013-01-01

Image fusion may be useful in any procedure where previous imaging such as positron emission tomography, magnetic resonance imaging, or contrast-enhanced computed tomography (CT) defines information that is referenced to the procedural imaging, to the needle or catheter, or to an ultrasound transducer. Fusion of prior and intraoperative imaging provides real-time feedback on tumor location or margin, metabolic activity, device location, or vessel location. Multimodality image fusion in interventional radiology was initially introduced for biopsies and ablations, especially for lesions only seen on arterial phase CT, magnetic resonance imaging, or positron emission tomography/CT but has more recently been applied to other vascular and nonvascular procedures. Two different types of platforms are commonly used for image fusion and navigation: (1) electromagnetic tracking and (2) cone-beam CT. Both technologies would be reviewed as well as their strengths and weaknesses, indications, when to use one vs the other, tips and guidance to streamline use, and early evidence defining clinical benefits of these rapidly evolving, commercially available and emerging techniques. PMID:23993079

Novel cooperative neural fusion algorithms for image restoration and image fusion.

PubMed

Xia, Youshen; Kamel, Mohamed S

2007-02-01

To deal with the problem of restoring degraded images with non-Gaussian noise, this paper proposes a novel cooperative neural fusion regularization (CNFR) algorithm for image restoration. Compared with conventional regularization algorithms for image restoration, the proposed CNFR algorithm can relax need of the optimal regularization parameter to be estimated. Furthermore, to enhance the quality of restored images, this paper presents a cooperative neural fusion (CNF) algorithm for image fusion. Compared with existing signal-level image fusion algorithms, the proposed CNF algorithm can greatly reduce the loss of contrast information under blind Gaussian noise environments. The performance analysis shows that the proposed two neural fusion algorithms can converge globally to the robust and optimal image estimate. Simulation results confirm that in different noise environments, the proposed two neural fusion algorithms can obtain a better image estimate than several well known image restoration and image fusion methods.

Visualizing deceleration-phase instabilities in inertial confinement fusion implosions using an "enhanced self-emission" technique at the National Ignition Facility

NASA Astrophysics Data System (ADS)

Pickworth, L. A.; Hammel, B. A.; Smalyuk, V. A.; Robey, H. F.; Benedetti, L. R.; Berzak Hopkins, L.; Bradley, D. K.; Field, J. E.; Haan, S. W.; Hatarik, R.; Hartouni, E.; Izumi, N.; Johnson, S.; Khan, S.; Lahmann, B.; Landen, O. L.; Le Pape, S.; MacPhee, A. G.; Meezan, N. B.; Milovich, J.; Nagel, S. R.; Nikroo, A.; Pak, A. E.; Petrasso, R.; Remington, B. A.; Rice, N. G.; Springer, P. T.; Stadermann, M.; Widmann, K.; Hsing, W.

2018-05-01

High-mode perturbations and low-mode asymmetries were measured in the deceleration phase of indirectly driven, deuterium gas filled inertial confinement fusion capsule implosions at convergence ratios of 10 to 15, using a new "enhanced emission" technique at the National Ignition Facility [E. M. Campbell et al., AIP Conf. Proc. 429, 3 (1998)]. In these experiments, a high spatial resolution Kirkpatrick-Baez microscope was used to image the x-ray emission from the inner surface of a high-density-carbon capsule's shell. The use of a high atomic number dopant in the shell enabled time-resolved observations of shell perturbations penetrating into the hot spot. This allowed the effects of the perturbations and asymmetries on degrading neutron yield to be directly measured. In particular, mix induced radiation losses of ˜400 J from the hot spot resulted in a neutron yield reduction of a factor of ˜2. In a subsequent experiment with a significantly increased level of short-mode initial perturbations, shown through the enhanced imaging technique to be highly organized radially, the neutron yield dropped an additional factor of ˜2.

Clinical outcome of trans-sacral interbody fusion after partial reduction for high-grade l5-s1 spondylolisthesis.

PubMed

Smith, J A; Deviren, V; Berven, S; Kleinstueck, F; Bradford, D S

2001-10-15

A clinical retrospective study was conducted. To evaluate the clinical and radiographic outcome of reduction followed by trans-sacral interbody fusion for high-grade spondylolisthesis. In situ posterior interbody fusion with fibula allograft has improved the fusion rates for patients with high-grade spondylolisthesis. The use of this technique in conjunction with partial reduction has not been reported. Nine consecutive patients underwent treatment of high-grade (Grade 3 or 4) spondylolisthesis with partial reduction followed by posterior interbody fusion using cortical allograft. The average age at the time of surgery was 27 years (range, 8-51 years), and the average follow-up period was 43 months (range, 24-72 months). Before surgery, eight patients had low back pain, seven patients had radiating leg pain, and five patients had hamstring tightness. The average grade of spondylolisthesis by Meyerding grading was 3.9 (range, 3-5). Charts and radiographs were evaluated, and outcomes were collected by use of the modified SRS outcomes instrument. Radiographic indexes demonstrated significant improvement with partial reduction and fusion. The slip angle, as measured from the inferior endplate of L5, improved from 41.2 degrees (range, 24-82 degrees ) before surgery to 21 degrees (range, 5-40 degrees ) after surgery. All the patients were extremely or somewhat satisfied with surgery. The two patients who underwent this operation without initial instrumentation experienced fractures of their interbody grafts. Both of these patients underwent repair of the pseudarthrosis with placement of trans-sacral pedicle screw instrumentation and subsequent fusion. Partial reduction followed by posterior interbody fusion is an effective technique for the management of high-grade spondylolisthesis in pediatric and adult patient populations, as assessed by radiographic and clinical criteria. Pedicle screw instrumentation with the sacral screws capturing L5 is recommended when this

Magnetic-confinement fusion

NASA Astrophysics Data System (ADS)

Ongena, J.; Koch, R.; Wolf, R.; Zohm, H.

2016-05-01

Our modern society requires environmentally friendly solutions for energy production. Energy can be released not only from the fission of heavy nuclei but also from the fusion of light nuclei. Nuclear fusion is an important option for a clean and safe solution for our long-term energy needs. The extremely high temperatures required for the fusion reaction are routinely realized in several magnetic-fusion machines. Since the early 1990s, up to 16 MW of fusion power has been released in pulses of a few seconds, corresponding to a power multiplication close to break-even. Our understanding of the very complex behaviour of a magnetized plasma at temperatures between 150 and 200 million °C surrounded by cold walls has also advanced substantially. This steady progress has resulted in the construction of ITER, a fusion device with a planned fusion power output of 500 MW in pulses of 400 s. ITER should provide answers to remaining important questions on the integration of physics and technology, through a full-size demonstration of a tenfold power multiplication, and on nuclear safety aspects. Here we review the basic physics underlying magnetic fusion: past achievements, present efforts and the prospects for future production of electrical energy. We also discuss questions related to the safety, waste management and decommissioning of a future fusion power plant.

Radar image and data fusion for natural hazards characterisation

USGS Publications Warehouse

Lu, Zhong; Dzurisin, Daniel; Jung, Hyung-Sup; Zhang, Jixian; Zhang, Yonghong

2010-01-01

Fusion of synthetic aperture radar (SAR) images through interferometric, polarimetric and tomographic processing provides an all - weather imaging capability to characterise and monitor various natural hazards. This article outlines interferometric synthetic aperture radar (InSAR) processing and products and their utility for natural hazards characterisation, provides an overview of the techniques and applications related to fusion of SAR/InSAR images with optical and other images and highlights the emerging SAR fusion technologies. In addition to providing precise land - surface digital elevation maps, SAR - derived imaging products can map millimetre - scale elevation changes driven by volcanic, seismic and hydrogeologic processes, by landslides and wildfires and other natural hazards. With products derived from the fusion of SAR and other images, scientists can monitor the progress of flooding, estimate water storage changes in wetlands for improved hydrological modelling predictions and assessments of future flood impacts and map vegetation structure on a global scale and monitor its changes due to such processes as fire, volcanic eruption and deforestation. With the availability of SAR images in near real - time from multiple satellites in the near future, the fusion of SAR images with other images and data is playing an increasingly important role in understanding and forecasting natural hazards.

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

PubMed

Astolfi, Rafael Haddad; Freschi, Gustavo; Berti, Fernando Figueiredo; Gattas, Nelson; Molina, Wilson Rica; Meller, Alex

2017-08-01

To analyze the results of flexible ureterorenoscopy (F-URS) with holmium laser in the treatment of kidney stones with ectopic and fusion anomalies (horseshoe kidney and rotation anomalies). We reviewed data from 13 patients with fusion and ectopic renal anomalies that underwent F-URS from April 2011 to April 2017. We analyzed demographic and clinical data (age, gender, BMI, anatomical abnormality, location and dimension of the renal calculi) and perioperative data (method of treatment, stone-free rate, number of days with DJ catheter and perioperative complications). The mean stone size was 12.23 +/- 5.43 mm (range 6-22mm), located in the inferior (58.33%) and middle (16.76%) calyceal units, renal pelvis (16.67%) and multiple locations (8.33%). All 13 patients were treated with Ho-Yag laser, using dusting technique (25%), fragmentation and extraction of the calculi (58.33%) and mixed technique (16.67%). We did not have any severe perioperative complication. After 90 days, nine patients (75%) were considered stone free. Our data suggest that F-URS is a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.

Multiview fusion for activity recognition using deep neural networks

NASA Astrophysics Data System (ADS)

Kavi, Rahul; Kulathumani, Vinod; Rohit, Fnu; Kecojevic, Vlad

2016-07-01

Convolutional neural networks (ConvNets) coupled with long short term memory (LSTM) networks have been recently shown to be effective for video classification as they combine the automatic feature extraction capabilities of a neural network with additional memory in the temporal domain. This paper shows how multiview fusion can be applied to such a ConvNet LSTM architecture. Two different fusion techniques are presented. The system is first evaluated in the context of a driver activity recognition system using data collected in a multicamera driving simulator. These results show significant improvement in accuracy with multiview fusion and also show that deep learning performs better than a traditional approach using spatiotemporal features even without requiring any background subtraction. The system is also validated on another publicly available multiview action recognition dataset that has 12 action classes and 8 camera views.

Potential advantage of studying the lymphatic drainage by sentinel node technique and SPECT-CT image fusion for pelvic irradiation of prostate cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krengli, Marco; Ballare, Andrea; Cannillo, Barbara

2006-11-15

Purpose: This study aims to investigate the in vivo drainage of lymphatic spread by using the sentinel node (SN) technique and single-photon emission computed tomography (SPECT)-computed tomography (CT) image fusion, and to analyze the impact of such information on conformal pelvic irradiation. Methods and Materials: Twenty-three prostate cancer patients, candidates for radical prostatectomy already included in a trial studying the SN technique, were enrolled. CT and SPECT images were obtained after intraprostate injection of 115 MBq of {sup 99m}Tc-nanocolloid, allowing identification of SN and other pelvic lymph nodes. Target and nontarget structures, including lymph nodes identified by SPECT, were drawnmore » on SPECT-CT fusion images. A three-dimensional conformal treatment plan was performed for each patient. Results: Single-photon emission computed tomography lymph nodal uptake was detected in 20 of 23 cases (87%). The SN was inside the pelvic clinical target volume (CTV{sub 2}) in 16 of 20 cases (80%) and received no less than the prescribed dose in 17 of 20 cases (85%). The most frequent locations of SN outside the CTV{sub 2} were the common iliac and presacral lymph nodes. Sixteen of the 32 other lymph nodes (50%) identified by SPECT were found outside the CTV{sub 2}. Overall, the SN and other intrapelvic lymph nodes identified by SPECT were not included in the CTV{sub 2} in 5 of 20 (25%) patients. Conclusions: The study of lymphatic drainage can contribute to a better knowledge of the in vivo potential pattern of lymph node metastasis in prostate cancer and can lead to a modification of treatment volume with consequent optimization of pelvic irradiation.« less

Pionic Fusion of 4He +12 C

NASA Astrophysics Data System (ADS)

Zarrella, Andrew; Yennello, Sherry

2017-09-01

Pionic fusion is the process by which two nuclei fuse and then deexcite by the exclusive emission of a pion. These reactions represent the most extreme examples of deep subthreshold pion production and provide evidence for an unknown, collective mechanism for pion production. An experiment was performed at the Texas A&M University Cyclotron Institute to measure the cross section of the 4He +12 C -> 16N +π+ reaction. The Momentum Achromat Recoil Spectrometer (MARS) was used to separate and identify the 16N fusion residues and the newly constructed Partial Truncated Icosahedron (ParTI) phoswich array was used to identify charged pions. The detector responses for each phoswich unit were recorded using fast-sampling ADCs which allow all light charged particles in the ParTI phoswiches to be identified using ``fast vs. slow'' pulse shape discrimination. By writing the waveform responses, pions can also be identified by the presence of a characteristic muon decay pulse. The combination of the residue-pion coincidence and the two independent pion identification techniques represent a highly sensitive experimental design for studying pionic fusion reactions.

3D Image Fusion to Localise Intercostal Arteries During TEVAR.

PubMed

Koutouzi, G; Sandström, C; Skoog, P; Roos, H; Falkenberg, M

2017-01-01

Preservation of intercostal arteries during thoracic aortic procedures reduces the risk of post-operative paraparesis. The origins of the intercostal arteries are visible on pre-operative computed tomography angiography (CTA), but rarely on intra-operative angiography. The purpose of this report is to suggest an image fusion technique for intra-operative localisation of the intercostal arteries during thoracic endovascular repair (TEVAR). The ostia of the intercostal arteries are identified and manually marked with rings on the pre-operative CTA. The optimal distal landing site in the descending aorta is determined and marked, allowing enough length for an adequate seal and attachment without covering more intercostal arteries than necessary. After 3D/3D fusion of the pre-operative CTA with an intra-operative cone-beam CT (CBCT), the markings are overlaid on the live fluoroscopy screen for guidance. The accuracy of the overlay is confirmed with digital subtraction angiography (DSA) and the overlay is adjusted when needed. Stent graft deployment is guided by the markings. The initial experience of this technique in seven patients is presented. 3D image fusion was feasible in all cases. Follow-up CTA after 1 month revealed that all intercostal arteries planned for preservation, were patent. None of the patients developed signs of spinal cord ischaemia. 3D image fusion can be used to localise the intercostal arteries during TEVAR. This may preserve some intercostal arteries and reduce the risk of post-operative spinal cord ischaemia.

FuzzyFusion: an application architecture for multisource information fusion

NASA Astrophysics Data System (ADS)

Fox, Kevin L.; Henning, Ronda R.

2009-04-01

The correlation of information from disparate sources has long been an issue in data fusion research. Traditional data fusion addresses the correlation of information from sources as diverse as single-purpose sensors to all-source multi-media information. Information system vulnerability information is similar in its diversity of sources and content, and in the desire to draw a meaningful conclusion, namely, the security posture of the system under inspection. FuzzyFusionTM, A data fusion model that is being applied to the computer network operations domain is presented. This model has been successfully prototyped in an applied research environment and represents a next generation assurance tool for system and network security.

Regional Distribution of Forest Height and Biomass from Multisensor Data Fusion

NASA Technical Reports Server (NTRS)

Yu, Yifan; Saatchi, Sassan; Heath, Linda S.; LaPoint, Elizabeth; Myneni, Ranga; Knyazikhin, Yuri

2010-01-01

Elevation data acquired from radar interferometry at C-band from SRTM are used in data fusion techniques to estimate regional scale forest height and aboveground live biomass (AGLB) over the state of Maine. Two fusion techniques have been developed to perform post-processing and parameter estimations from four data sets: 1 arc sec National Elevation Data (NED), SRTM derived elevation (30 m), Landsat Enhanced Thematic Mapper (ETM) bands (30 m), derived vegetation index (VI) and NLCD2001 land cover map. The first fusion algorithm corrects for missing or erroneous NED data using an iterative interpolation approach and produces distribution of scattering phase centers from SRTM-NED in three dominant forest types of evergreen conifers, deciduous, and mixed stands. The second fusion technique integrates the USDA Forest Service, Forest Inventory and Analysis (FIA) ground-based plot data to develop an algorithm to transform the scattering phase centers into mean forest height and aboveground biomass. Height estimates over evergreen (R2 = 0.86, P < 0.001; RMSE = 1.1 m) and mixed forests (R2 = 0.93, P < 0.001, RMSE = 0.8 m) produced the best results. Estimates over deciduous forests were less accurate because of the winter acquisition of SRTM data and loss of scattering phase center from tree ]surface interaction. We used two methods to estimate AGLB; algorithms based on direct estimation from the scattering phase center produced higher precision (R2 = 0.79, RMSE = 25 Mg/ha) than those estimated from forest height (R2 = 0.25, RMSE = 66 Mg/ha). We discuss sources of uncertainty and implications of the results in the context of mapping regional and continental scale forest biomass distribution.

The fusion of large scale classified side-scan sonar image mosaics.

PubMed

Reed, Scott; Tena, Ruiz Ioseba; Capus, Chris; Petillot, Yvan

2006-07-01

This paper presents a unified framework for the creation of classified maps of the seafloor from sonar imagery. Significant challenges in photometric correction, classification, navigation and registration, and image fusion are addressed. The techniques described are directly applicable to a range of remote sensing problems. Recent advances in side-scan data correction are incorporated to compensate for the sonar beam pattern and motion of the acquisition platform. The corrected images are segmented using pixel-based textural features and standard classifiers. In parallel, the navigation of the sonar device is processed using Kalman filtering techniques. A simultaneous localization and mapping framework is adopted to improve the navigation accuracy and produce georeferenced mosaics of the segmented side-scan data. These are fused within a Markovian framework and two fusion models are presented. The first uses a voting scheme regularized by an isotropic Markov random field and is applicable when the reliability of each information source is unknown. The Markov model is also used to inpaint regions where no final classification decision can be reached using pixel level fusion. The second model formally introduces the reliability of each information source into a probabilistic model. Evaluation of the two models using both synthetic images and real data from a large scale survey shows significant quantitative and qualitative improvement using the fusion approach.

Electron cyclotron emission imaging and applications in magnetic fusion energy

NASA Astrophysics Data System (ADS)

Tobias, Benjamin John

Energy production through the burning of fossil fuels is an unsustainable practice. Exponentially increasing energy consumption and dwindling natural resources ensure that coal and gas fueled power plants will someday be a thing of the past. However, even before fuel reserves are depleted, our planet may well succumb to disastrous side effects, namely the build up of carbon emissions in the environment triggering world-wide climate change and the countless industrial spills of pollutants that continue to this day. Many alternatives are currently being developed, but none has so much promise as fusion nuclear energy, the energy of the sun. The confinement of hot plasma at temperatures in excess of 100 million Kelvin by a carefully arranged magnetic field for the realization of a self-sustaining fusion power plant requires new technologies and improved understanding of fundamental physical phenomena. Imaging of electron cyclotron radiation lends insight into the spatial and temporal behavior of electron temperature fluctuations and instabilities, providing a powerful diagnostic for investigations into basic plasma physics and nuclear fusion reactor operation. This dissertation presents the design and implementation of a new generation of Electron Cyclotron Emission Imaging (ECEI) diagnostics on toroidal magnetic fusion confinement devices, or tokamaks, around the world. The underlying physics of cyclotron radiation in fusion plasmas is reviewed, and a thorough discussion of millimeter wave imaging techniques and heterodyne radiometry in ECEI follows. The imaging of turbulence and fluid flows has evolved over half a millennium since Leonardo da Vinci's first sketches of cascading water, and applications for ECEI in fusion research are broad ranging. Two areas of physical investigation are discussed in this dissertation: the identification of poloidal shearing in Alfven eigenmode structures predicted by hybrid gyrofluid-magnetohydrodynamic (gyrofluid-MHD) modeling, and

Image fusion via nonlocal sparse K-SVD dictionary learning.

PubMed

Li, Ying; Li, Fangyi; Bai, Bendu; Shen, Qiang

2016-03-01

Image fusion aims to merge two or more images captured via various sensors of the same scene to construct a more informative image by integrating their details. Generally, such integration is achieved through the manipulation of the representations of the images concerned. Sparse representation plays an important role in the effective description of images, offering a great potential in a variety of image processing tasks, including image fusion. Supported by sparse representation, in this paper, an approach for image fusion by the use of a novel dictionary learning scheme is proposed. The nonlocal self-similarity property of the images is exploited, not only at the stage of learning the underlying description dictionary but during the process of image fusion. In particular, the property of nonlocal self-similarity is combined with the traditional sparse dictionary. This results in an improved learned dictionary, hereafter referred to as the nonlocal sparse K-SVD dictionary (where K-SVD stands for the K times singular value decomposition that is commonly used in the literature), and abbreviated to NL_SK_SVD. The performance of the NL_SK_SVD dictionary is applied for image fusion using simultaneous orthogonal matching pursuit. The proposed approach is evaluated with different types of images, and compared with a number of alternative image fusion techniques. The resultant superior fused images using the present approach demonstrates the efficacy of the NL_SK_SVD dictionary in sparse image representation.

EDITORIAL: Safety aspects of fusion power plants

NASA Astrophysics Data System (ADS)

Kolbasov, B. N.

2007-07-01

neutral beam injectors and the power supply systems were considered. This year the ion cyclotron resonant heating system is under evaluation. I. Cristescu et al (Germany) present the paper `Tritium inventories and tritium safety design principles for the fuel cycle of ITER'. She and her colleagues developed the dynamic mathematical model (TRIMO) for tritium inventory evaluation within each system of the ITER fuel cycle in various operational scenarios. TRIMO is used as a tool for trade-off studies within the fuel cycle systems with the final goal of global tritium inventory minimization. M. Matsuyama et al (Japan) describes a new technique for in situ quantitative measurements of high-level tritium inventory and its distribution in the VV and tritium systems of ITER and future fusion reactors. This technique is based on utilization of x-rays induced by beta-rays emitting from tritium species. It was applied to three physical states of high-level tritium: to gaseous, aqueous and solid tritium retained on/in various materials. Finally, there are four papers devoted to safety issues in fusion reactor decommissioning and waste management. A paper by R. Pampin et al (UK) provides the revised radioactive waste analysis of two models in the PPCS. Another paper by M. Zucchetti (Italy), S.A. Bartenev (Russia) et al describes a radiochemical extraction technology for purification of V-Cr-Ti alloy components from activation products to the dose rate of 10 µSv/h allowing their clearance or hands-on recycling which has been developed and tested in laboratory stationary conditions. L. El-Guebaly (USA) and her colleagues submitted two papers. In the first paper she optimistically considers the possibility of replacing the disposal of fusion power reactor waste with recycling and clearance. Her second paper considers the implications of new clearance guidelines for nuclear applications, particularly for slightly irradiated fusion materials.

Four-corner fusion of the wrist: clinical and radiographic outcome of 31 patients.

PubMed

Mavrogenis, Andreas F; Flevas, Dimitrios A; Raptis, Konstantinos; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios G; Antoniadou, Thekla; Dimopoulos, Leonidas; Antonopoulos, Dimitrios; Spyridonos, Sarantis G

2016-12-01

Four-corner fusion is a rational surgical option for the management of degenerative conditions of the wrist. Most related studies have compared four-corner fusion with scaphoid excision or proximal row carpectomy, with a variety of reported results. To enhance the literature, we performed this study to evaluate a series of patients with degenerative conditions of the wrist treated with four-corner fusion using 3 surgical techniques and to discuss the clinical and radiographic outcome of the patients. We retrospectively studied 31 patients (24 men, 7 women; mean age, 43 years; 9 heavy manual laborers) who underwent four-corner fusion of their wrists for degenerative conditions from 2005 to 2015. Internal fixation was done using multiple Kirschner wires (14 patients), headless compressive screws (8 patients), or a circular plate (9 patients). Mean follow-up was 4 years (1-11 years). We evaluated the clinical outcome with the Patient-Rated Wrist Evaluation (PRWE) score and fusion with radiographs. All patients experienced improvement of their pain, function, range of motion and grip strength (p < 0.05). Twenty-three patients (74 %) reported no pain, and eight patients reported mild, occasional pain. Twenty-one patients (68 %) were able to do usual and specific activities. Mean wrist motion improved to 70 % and mean grip strength improved to 85 % of opposite wrist. Two heavy manual labor patients requested a job modification because of wrist impairment. Radiographs of the wrist showed fusion of all fused joints in 28 (90.3 %) patients and partial fusion in three patients (9.7 %). No patient with partial fusion required a reoperation for symptomatic nonunion until the period of this study. Three patients experienced complications (10 %). Two patients treated with a circular plate experienced complex regional pain syndrome and painful implant impingement; another patient treated with Kirschner wires and headless compression screws experienced radiolunate

Whitacre Needle Reduces the Incidence of Intravascular Uptake in Lumbar Transforaminal Epidural Steroid Injections.

PubMed

Hong, JiHee; Jung, Sungwon; Chang, Hyuckwon

2015-01-01

Transforaminal epidural steroid injection (TFESI) is a commonly used interventional pain management procedures to treat radicular leg pain. Although most reported complications of TFESI are minor, serious morbidity has also been demonstrated including spinal cord infarction, paraplegia, and quadriparesis. Suggested mechanisms include direct vascular injury or intravascular injection of particulate steroid. We compared 2 different needle types, Whitacre and Quincke type needles, with regard to intravascular injection rate with total procedure time and the amount of radiation during lumbar TFESI. Prospective, randomized trial. An interventional pain management practice in South Korea. After Institutional Review Board approval, 149 patients undergoing lumbar TFESI for radicular leg pain were randomly assigned to one of 2 needle groups (Whitacre needle or Quincke type needle). After final confirmation of intravascular injection with digital subtraction angiography, total procedure time and amount of radiation exposure during TFESI were measured. The overall incidence of intravascular injection was 10.4% (28/269). We analyzed the overall incidence of intravascular injection according to the 2 different needle types. The incidence of intravascular injection of the Whitacre needle was 5.4% (8/146), whereas the incidence of intravascular injection of the Quincke needle was 16.2% (20/123). Total procedure time and amount of radiation required to complete the TFESI in the Whitacre and Quincke needle groups was 168.4 ± 57.9 (seconds) and 33.4 ± 15.9 (cGy/cm2), 131.9 ± 46.0 (seconds) and 33.2 ± 15.8 (cGy/cm2), respectively. The physician who performed the TFESI was not blinded to the type of needle for detecting intravascular injection. This study was focused on lumbar TFESI, however, most TFESIs are performed at the L4-5 or L5-S1 level. The Whitacre needle had the benefit of reducing the incidence of intravascular injection with minimal differences in technical

Minimally invasive versus open sacroiliac joint fusion: are they similarly safe and effective?

PubMed

Ledonio, Charles G T; Polly, David W; Swiontkowski, Marc F

2014-06-01

The sacroiliac joint has been implicated as a source of chronic low back pain in 15% to 30% of patients. When nonsurgical approaches fail, sacroiliac joint fusion may be recommended. Advances in intraoperative image guidance have assisted minimally invasive surgical (MIS) techniques using ingrowth-coated fusion rods; however, how these techniques perform relative to open anterior fusion of the sacroiliac joint using plates and screws is not known. We compared estimated blood loss (EBL), surgical time, length of hospital stay (LOS), and Oswestry Disability Index (ODI) between patients undergoing MIS and open sacroiliac joint fusion. We retrospectively studied 63 patients (open: 36; MIS: 27) who underwent sacroiliac joint fusion with minimum 1-year followup at our institution from 2006 to 2011. Of those, 10 in the open group had incomplete records. All patients had sacroiliac joint dysfunction confirmed by image-guided intraarticular anesthetic sacroiliac joint injection and had failed nonoperative treatment. Patients were matched via propensity score, adjusting for age, sex, BMI, history of spine fusion, and preoperative ODI scores, leaving 22 in each group. Nine patients were not matched. We reviewed patient medical records to obtain EBL, length of surgery, LOS, and pre- and postoperative ODI scores. Mean followup was 13 months (range, 11-33 months) in the open group and 15 months (range, 12-26 months) in the MIS group. Patients in the open group had a higher mean EBL (681 mL versus 41 mL, p < 0.001). Mean surgical time and LOS were shorter in the MIS group than in the open group (68 minutes versus 128 minutes and 3.3 days versus 2 days, p < 0.001 for both). With the numbers available, mean postoperative ODI scores were not different between groups (47% versus 54%, p = 0.272). EBL, surgery time, and LOS favored the MIS sacroiliac fusion group. With the numbers available, ODI scores were similar between groups, though the study size was relatively small and it is

Hendra virus fusion protein transmembrane domain contributes to pre-fusion protein stability

PubMed Central

Webb, Stacy; Nagy, Tamas; Moseley, Hunter; Fried, Michael; Dutch, Rebecca

2017-01-01

Enveloped viruses utilize fusion (F) proteins studding the surface of the virus to facilitate membrane fusion with a target cell membrane. Fusion of the viral envelope with a cellular membrane is required for release of viral genomic material, so the virus can ultimately reproduce and spread. To drive fusion, the F protein undergoes an irreversible conformational change, transitioning from a metastable pre-fusion conformation to a more thermodynamically stable post-fusion structure. Understanding the elements that control stability of the pre-fusion state and triggering to the post-fusion conformation is important for understanding F protein function. Mutations in F protein transmembrane (TM) domains implicated the TM domain in the fusion process, but the structural and molecular details in fusion remain unclear. Previously, analytical ultracentrifugation was utilized to demonstrate that isolated TM domains of Hendra virus F protein associate in a monomer-trimer equilibrium (Smith, E. C., Smith, S. E., Carter, J. R., Webb, S. R., Gibson, K. M., Hellman, L. M., Fried, M. G., and Dutch, R. E. (2013) J. Biol. Chem. 288, 35726–35735). To determine factors driving this association, 140 paramyxovirus F protein TM domain sequences were analyzed. A heptad repeat of β-branched residues was found, and analysis of the Hendra virus F TM domain revealed a heptad repeat leucine-isoleucine zipper motif (LIZ). Replacement of the LIZ with alanine resulted in dramatically reduced TM-TM association. Mutation of the LIZ in the whole protein resulted in decreased protein stability, including pre-fusion conformation stability. Together, our data suggest that the heptad repeat LIZ contributed to TM-TM association and is important for F protein function and pre-fusion stability. PMID:28213515

Rapid Method for Sodium Hydroxide/Sodium Peroxide Fusion ...

EPA Pesticide Factsheets

Technical Fact Sheet Analysis Purpose: Qualitative analysis Technique: Alpha spectrometry Method Developed for: Plutonium-238 and plutonium-239 in water and air filters Method Selected for: SAM lists this method as a pre-treatment technique supporting analysis of refractory radioisotopic forms of plutonium in drinking water and air filters using the following qualitative techniques: • Rapid methods for acid or fusion digestion • Rapid Radiochemical Method for Plutonium-238 and Plutonium 239/240 in Building Materials for Environmental Remediation Following Radiological Incidents. Summary of subject analytical method which will be posted to the SAM website to allow access to the method.

Trust metrics in information fusion

NASA Astrophysics Data System (ADS)

Blasch, Erik

2014-05-01

Trust is an important concept for machine intelligence and is not consistent across many applications. In this paper, we seek to understand trust from a variety of factors: humans, sensors, communications, intelligence processing algorithms and human-machine displays of information. In modeling the various aspects of trust, we provide an example from machine intelligence that supports the various attributes of measuring trust such as sensor accuracy, communication timeliness, machine processing confidence, and display throughput to convey the various attributes that support user acceptance of machine intelligence results. The example used is fusing video and text whereby an analyst needs trust information in the identified imagery track. We use the proportional conflict redistribution rule as an information fusion technique that handles conflicting data from trusted and mistrusted sources. The discussion of the many forms of trust explored in the paper seeks to provide a systems-level design perspective for information fusion trust quantification.

Characterization of fusion genes and the significantly expressed fusion isoforms in breast cancer by hybrid sequencing

PubMed Central

Weirather, Jason L.; Afshar, Pegah Tootoonchi; Clark, Tyson A.; Tseng, Elizabeth; Powers, Linda S.; Underwood, Jason G.; Zabner, Joseph; Korlach, Jonas; Wong, Wing Hung; Au, Kin Fai

2015-01-01

We developed an innovative hybrid sequencing approach, IDP-fusion, to detect fusion genes, determine fusion sites and identify and quantify fusion isoforms. IDP-fusion is the first method to study gene fusion events by integrating Third Generation Sequencing long reads and Second Generation Sequencing short reads. We applied IDP-fusion to PacBio data and Illumina data from the MCF-7 breast cancer cells. Compared with the existing tools, IDP-fusion detects fusion genes at higher precision and a very low false positive rate. The results show that IDP-fusion will be useful for unraveling the complexity of multiple fusion splices and fusion isoforms within tumorigenesis-relevant fusion genes. PMID:26040699

Application of ECT inspection to the first wall of a fusion reactor with wavelet analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, G.; Yoshida, Y.; Miya, K.

1994-12-31

The first wall of a fusion reactor will be subjected to intensive loads during fusion operations. Since these loads may cause defects in the first wall, nondestructive evaluation techniques of the first wall should be developed. In this paper, we try to apply eddy current testing (ECT) technique to the inspection of the first wall. A method based on current vector potential and wavelet analysis is proposed. Owing to the use of wavelet analysis, a new theory developed recently, the accuracy of the present method is shown to be better than a conventional one.

Impact of monaural frequency compression on binaural fusion at the brainstem level.

PubMed

Klauke, Isabelle; Kohl, Manuel C; Hannemann, Ronny; Kornagel, Ulrich; Strauss, Daniel J; Corona-Strauss, Farah I

2015-08-01

A classical objective measure for binaural fusion at the brainstem level is the so-called β-wave of the binaural interaction component (BIC) in the auditory brainstem response (ABR). However, in some cases it appeared that a reliable detection of this component still remains a challenge. In this study, we investigate the wavelet phase synchronization stability (WPSS) of ABR data for the analysis of binaural fusion and compare it to the BIC. In particular, we examine the impact of monaural nonlinear frequency compression on binaural fusion. As the auditory system is tonotopically organized, an interaural frequency mismatch caused by monaural frequency compression could negatively effect binaural fusion. In this study, only few subjects showed a detectable β-wave and in most cases only for low ITDs. However, we present a novel objective measure for binaural fusion that outperforms the current state-of-the-art technique (BIC): the WPSS analysis showed a significant difference between the phase stability of the sum of the monaurally evoked responses and the phase stability of the binaurally evoked ABR. This difference could be an indicator for binaural fusion in the brainstem. Furthermore, we observed that monaural frequency compression could indeed effect binaural fusion, as the WPSS results for this condition vary strongly from the results obtained without frequency compression.

Muon Catalyzed Fusion

NASA Technical Reports Server (NTRS)

Armour, Edward A.G.

2007-01-01

Muon catalyzed fusion is a process in which a negatively charged muon combines with two nuclei of isotopes of hydrogen, e.g, a proton and a deuteron or a deuteron and a triton, to form a muonic molecular ion in which the binding is so tight that nuclear fusion occurs. The muon is normally released after fusion has taken place and so can catalyze further fusions. As the muon has a mean lifetime of 2.2 microseconds, this is the maximum period over which a muon can participate in this process. This article gives an outline of the history of muon catalyzed fusion from 1947, when it was first realised that such a process might occur, to the present day. It includes a description of the contribution that Drachrnan has made to the theory of muon catalyzed fusion and the influence this has had on the author's research.

Hendra virus fusion protein transmembrane domain contributes to pre-fusion protein stability.

PubMed

Webb, Stacy; Nagy, Tamas; Moseley, Hunter; Fried, Michael; Dutch, Rebecca

2017-04-07

Enveloped viruses utilize fusion (F) proteins studding the surface of the virus to facilitate membrane fusion with a target cell membrane. Fusion of the viral envelope with a cellular membrane is required for release of viral genomic material, so the virus can ultimately reproduce and spread. To drive fusion, the F protein undergoes an irreversible conformational change, transitioning from a metastable pre-fusion conformation to a more thermodynamically stable post-fusion structure. Understanding the elements that control stability of the pre-fusion state and triggering to the post-fusion conformation is important for understanding F protein function. Mutations in F protein transmembrane (TM) domains implicated the TM domain in the fusion process, but the structural and molecular details in fusion remain unclear. Previously, analytical ultracentrifugation was utilized to demonstrate that isolated TM domains of Hendra virus F protein associate in a monomer-trimer equilibrium (Smith, E. C., Smith, S. E., Carter, J. R., Webb, S. R., Gibson, K. M., Hellman, L. M., Fried, M. G., and Dutch, R. E. (2013) J. Biol. Chem. 288, 35726-35735). To determine factors driving this association, 140 paramyxovirus F protein TM domain sequences were analyzed. A heptad repeat of β-branched residues was found, and analysis of the Hendra virus F TM domain revealed a heptad repeat leucine-isoleucine zipper motif (LIZ). Replacement of the LIZ with alanine resulted in dramatically reduced TM-TM association. Mutation of the LIZ in the whole protein resulted in decreased protein stability, including pre-fusion conformation stability. Together, our data suggest that the heptad repeat LIZ contributed to TM-TM association and is important for F protein function and pre-fusion stability. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

FusionAnalyser: a new graphical, event-driven tool for fusion rearrangements discovery

PubMed Central

Piazza, Rocco; Pirola, Alessandra; Spinelli, Roberta; Valletta, Simona; Redaelli, Sara; Magistroni, Vera; Gambacorti-Passerini, Carlo

2012-01-01

Gene fusions are common driver events in leukaemias and solid tumours; here we present FusionAnalyser, a tool dedicated to the identification of driver fusion rearrangements in human cancer through the analysis of paired-end high-throughput transcriptome sequencing data. We initially tested FusionAnalyser by using a set of in silico randomly generated sequencing data from 20 known human translocations occurring in cancer and subsequently using transcriptome data from three chronic and three acute myeloid leukaemia samples. in all the cases our tool was invariably able to detect the presence of the correct driver fusion event(s) with high specificity. In one of the acute myeloid leukaemia samples, FusionAnalyser identified a novel, cryptic, in-frame ETS2–ERG fusion. A fully event-driven graphical interface and a flexible filtering system allow complex analyses to be run in the absence of any a priori programming or scripting knowledge. Therefore, we propose FusionAnalyser as an efficient and robust graphical tool for the identification of functional rearrangements in the context of high-throughput transcriptome sequencing data. PMID:22570408

FusionAnalyser: a new graphical, event-driven tool for fusion rearrangements discovery.

PubMed

Piazza, Rocco; Pirola, Alessandra; Spinelli, Roberta; Valletta, Simona; Redaelli, Sara; Magistroni, Vera; Gambacorti-Passerini, Carlo

2012-09-01

Gene fusions are common driver events in leukaemias and solid tumours; here we present FusionAnalyser, a tool dedicated to the identification of driver fusion rearrangements in human cancer through the analysis of paired-end high-throughput transcriptome sequencing data. We initially tested FusionAnalyser by using a set of in silico randomly generated sequencing data from 20 known human translocations occurring in cancer and subsequently using transcriptome data from three chronic and three acute myeloid leukaemia samples. in all the cases our tool was invariably able to detect the presence of the correct driver fusion event(s) with high specificity. In one of the acute myeloid leukaemia samples, FusionAnalyser identified a novel, cryptic, in-frame ETS2-ERG fusion. A fully event-driven graphical interface and a flexible filtering system allow complex analyses to be run in the absence of any a priori programming or scripting knowledge. Therefore, we propose FusionAnalyser as an efficient and robust graphical tool for the identification of functional rearrangements in the context of high-throughput transcriptome sequencing data.

Genetic analysis of Bacillus stearothermophilus by protoplast fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Z.; Wojcik, S.F.; Welker, N.E.

1986-03-01

Efficient and reliable protoplasting, regeneration, and fusion techniques were established for the prototrophic strain Bacillus stearothermophilus NUB36. Auxotrophic mutants were isolated, and protoplast fusion was used to construct isogenic mutant strains and for chromosomal mapping. Markers were mapped using two-, three-, and four-factor crosses. The order of the markers was hom-1-thr-1-his-1-(gly-1 or gly-2)-pur-1-pur-2. These markers may be analogous to hom, thrA, hisA, glyC, and purA markers on the Bacillus subtilis chromosome. No analogous pur-1 marker has been reported in B. subtilis. The relative order of three of the markers (hom-1-thr-1-gly-1) was independently confirmed by transduction.

Characterization of fusion genes and the significantly expressed fusion isoforms in breast cancer by hybrid sequencing.

PubMed

Weirather, Jason L; Afshar, Pegah Tootoonchi; Clark, Tyson A; Tseng, Elizabeth; Powers, Linda S; Underwood, Jason G; Zabner, Joseph; Korlach, Jonas; Wong, Wing Hung; Au, Kin Fai

2015-10-15

We developed an innovative hybrid sequencing approach, IDP-fusion, to detect fusion genes, determine fusion sites and identify and quantify fusion isoforms. IDP-fusion is the first method to study gene fusion events by integrating Third Generation Sequencing long reads and Second Generation Sequencing short reads. We applied IDP-fusion to PacBio data and Illumina data from the MCF-7 breast cancer cells. Compared with the existing tools, IDP-fusion detects fusion genes at higher precision and a very low false positive rate. The results show that IDP-fusion will be useful for unraveling the complexity of multiple fusion splices and fusion isoforms within tumorigenesis-relevant fusion genes. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Hybrid Instrumentation in Lumbar Spinal Fusion: A Biomechanical Evaluation of Three Different Instrumentation Techniques.

PubMed

Obid, Peter; Danyali, Reza; Kueny, Rebecca; Huber, Gerd; Reichl, Michael; Richter, Alexander; Niemeyer, Thomas; Morlock, Michael; Püschel, Klaus; Übeyli, Hüseyin

2017-02-01

Ex vivo human cadaveric study. The development or progression of adjacent segment disease (ASD) after spine stabilization and fusion is a major problem in spine surgery. Apart from optimal balancing of the sagittal profile, dynamic instrumentation is often suggested to prevent or impede ASD. Hybrid instrumentation is used to gain stabilization while allowing motion to avoid hypermobility in the adjacent segment. In this biomechanical study, the effects of two different hybrid instrumentations on human cadaver spines were evaluated and compared with a rigid instrumentation. Eighteen human cadaver spines (T11-L5) were subdivided into three groups: rigid, dynamic, and hook comprising six spines each. Clinical parameters and initial mechanical characteristics were consistent among groups. All specimens received rigid fixation from L3-L5 followed by application of a free bending load of extension and flexion. The range of motion (ROM) for every segment was evaluated. For the rigid group, further rigid fixation from L1-L5 was applied. A dynamic Elaspine system (Spinelab AG, Winterthur, Switzerland) was applied from L1 to L3 for the dynamic group, and the hook group was instrumented with additional laminar hooks at L1-L3. ROM was then evaluated again. There was no significant difference in ROM among the three instrumentation techniques. Based on this data, the intended advantage of a hybrid or dynamic instrumentation might not be achieved.

Multispectral image fusion for illumination-invariant palmprint recognition

PubMed Central

Zhang, Xinman; Xu, Xuebin; Shang, Dongpeng

2017-01-01

Multispectral palmprint recognition has shown broad prospects for personal identification due to its high accuracy and great stability. In this paper, we develop a novel illumination-invariant multispectral palmprint recognition method. To combine the information from multiple spectral bands, an image-level fusion framework is completed based on a fast and adaptive bidimensional empirical mode decomposition (FABEMD) and a weighted Fisher criterion. The FABEMD technique decomposes the multispectral images into their bidimensional intrinsic mode functions (BIMFs), on which an illumination compensation operation is performed. The weighted Fisher criterion is to construct the fusion coefficients at the decomposition level, making the images be separated correctly in the fusion space. The image fusion framework has shown strong robustness against illumination variation. In addition, a tensor-based extreme learning machine (TELM) mechanism is presented for feature extraction and classification of two-dimensional (2D) images. In general, this method has fast learning speed and satisfying recognition accuracy. Comprehensive experiments conducted on the PolyU multispectral palmprint database illustrate that the proposed method can achieve favorable results. For the testing under ideal illumination, the recognition accuracy is as high as 99.93%, and the result is 99.50% when the lighting condition is unsatisfied. PMID:28558064

Multispectral image fusion for illumination-invariant palmprint recognition.

PubMed

Lu, Longbin; Zhang, Xinman; Xu, Xuebin; Shang, Dongpeng

2017-01-01

Multispectral palmprint recognition has shown broad prospects for personal identification due to its high accuracy and great stability. In this paper, we develop a novel illumination-invariant multispectral palmprint recognition method. To combine the information from multiple spectral bands, an image-level fusion framework is completed based on a fast and adaptive bidimensional empirical mode decomposition (FABEMD) and a weighted Fisher criterion. The FABEMD technique decomposes the multispectral images into their bidimensional intrinsic mode functions (BIMFs), on which an illumination compensation operation is performed. The weighted Fisher criterion is to construct the fusion coefficients at the decomposition level, making the images be separated correctly in the fusion space. The image fusion framework has shown strong robustness against illumination variation. In addition, a tensor-based extreme learning machine (TELM) mechanism is presented for feature extraction and classification of two-dimensional (2D) images. In general, this method has fast learning speed and satisfying recognition accuracy. Comprehensive experiments conducted on the PolyU multispectral palmprint database illustrate that the proposed method can achieve favorable results. For the testing under ideal illumination, the recognition accuracy is as high as 99.93%, and the result is 99.50% when the lighting condition is unsatisfied.

Sensor Fusion and Smart Sensor in Sports and Biomedical Applications

PubMed Central

Mendes, José Jair Alves; Vieira, Mário Elias Marinho; Pires, Marcelo Bissi; Stevan, Sergio Luiz

2016-01-01

The following work presents an overview of smart sensors and sensor fusion targeted at biomedical applications and sports areas. In this work, the integration of these areas is demonstrated, promoting a reflection about techniques and applications to collect, quantify and qualify some physical variables associated with the human body. These techniques are presented in various biomedical and sports applications, which cover areas related to diagnostics, rehabilitation, physical monitoring, and the development of performance in athletes, among others. Although some applications are described in only one of two fields of study (biomedicine and sports), it is very likely that the same application fits in both, with small peculiarities or adaptations. To illustrate the contemporaneity of applications, an analysis of specialized papers published in the last six years has been made. In this context, the main characteristic of this review is to present the largest quantity of relevant examples of sensor fusion and smart sensors focusing on their utilization and proposals, without deeply addressing one specific system or technique, to the detriment of the others. PMID:27669260

Fault diagnosis model for power transformers based on information fusion

NASA Astrophysics Data System (ADS)

Dong, Ming; Yan, Zhang; Yang, Li; Judd, Martin D.

2005-07-01

Methods used to assess the insulation status of power transformers before they deteriorate to a critical state include dissolved gas analysis (DGA), partial discharge (PD) detection and transfer function techniques, etc. All of these approaches require experience in order to correctly interpret the observations. Artificial intelligence (AI) is increasingly used to improve interpretation of the individual datasets. However, a satisfactory diagnosis may not be obtained if only one technique is used. For example, the exact location of PD cannot be predicted if only DGA is performed. However, using diverse methods may result in different diagnosis solutions, a problem that is addressed in this paper through the introduction of a fuzzy information infusion model. An inference scheme is proposed that yields consistent conclusions and manages the inherent uncertainty in the various methods. With the aid of information fusion, a framework is established that allows different diagnostic tools to be combined in a systematic way. The application of information fusion technique for insulation diagnostics of transformers is proved promising by means of examples.

Sensor Fusion and Smart Sensor in Sports and Biomedical Applications.

PubMed

Mendes, José Jair Alves; Vieira, Mário Elias Marinho; Pires, Marcelo Bissi; Stevan, Sergio Luiz

2016-09-23

The following work presents an overview of smart sensors and sensor fusion targeted at biomedical applications and sports areas. In this work, the integration of these areas is demonstrated, promoting a reflection about techniques and applications to collect, quantify and qualify some physical variables associated with the human body. These techniques are presented in various biomedical and sports applications, which cover areas related to diagnostics, rehabilitation, physical monitoring, and the development of performance in athletes, among others. Although some applications are described in only one of two fields of study (biomedicine and sports), it is very likely that the same application fits in both, with small peculiarities or adaptations. To illustrate the contemporaneity of applications, an analysis of specialized papers published in the last six years has been made. In this context, the main characteristic of this review is to present the largest quantity of relevant examples of sensor fusion and smart sensors focusing on their utilization and proposals, without deeply addressing one specific system or technique, to the detriment of the others.

Nuclear Fusion prize laudation Nuclear Fusion prize laudation

NASA Astrophysics Data System (ADS)

Burkart, W.

2011-01-01

Clean energy in abundance will be of critical importance to the pursuit of world peace and development. As part of the IAEA's activities to facilitate the dissemination of fusion related science and technology, the journal Nuclear Fusion is intended to contribute to the realization of such energy from fusion. In 2010, we celebrated the 50th anniversary of the IAEA journal. The excellence of research published in the journal is attested to by its high citation index. The IAEA recognizes excellence by means of an annual prize awarded to the authors of papers judged to have made the greatest impact. On the occasion of the 2010 IAEA Fusion Energy Conference in Daejeon, Republic of Korea at the welcome dinner hosted by the city of Daejeon, we celebrated the achievements of the 2009 and 2010 Nuclear Fusion prize winners. Steve Sabbagh, from the Department of Applied Physics and Applied Mathematics, Columbia University, New York is the winner of the 2009 award for his paper: 'Resistive wall stabilized operation in rotating high beta NSTX plasmas' [1]. This is a landmark paper which reports record parameters of beta in a large spherical torus plasma and presents a thorough investigation of the physics of resistive wall mode (RWM) instability. The paper makes a significant contribution to the critical topic of RWM stabilization. John Rice, from the Plasma Science and Fusion Center, MIT, Cambridge is the winner of the 2010 award for his paper: 'Inter-machine comparison of intrinsic toroidal rotation in tokamaks' [2]. The 2010 award is for a seminal paper that analyzes results across a range of machines in order to develop a universal scaling that can be used to predict intrinsic rotation. This paper has already triggered a wealth of experimental and theoretical work. I congratulate both authors and their colleagues on these exceptional papers. W. Burkart Deputy Director General Department of Nuclear Sciences and Applications International Atomic Energy Agency, Vienna

Measuring time of flight of fusion products in an inertial electrostatic confinement fusion device for spatial profiling of fusion reactions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donovan, D. C.; Boris, D. R.; Kulcinski, G. L.

2013-03-15

A new diagnostic has been developed that uses the time of flight (TOF) of the products from a nuclear fusion reaction to determine the location where the fusion reaction occurred. The TOF diagnostic uses charged particle detectors on opposing sides of the inertial electrostatic confinement (IEC) device that are coupled to high resolution timing electronics to measure the spatial profile of fusion reactions occurring between the two charged particle detectors. This diagnostic was constructed and tested by the University of Wisconsin-Madison Inertial Electrostatic Confinement Fusion Group in the IEC device, HOMER, which accelerates deuterium ions to fusion relevant energies inmore » a high voltage ({approx}100 kV), spherically symmetric, electrostatic potential well [J. F. Santarius, G. L. Kulcinski, R. P. Ashley, D. R. Boris, B. B. Cipiti, S. K. Murali, G. R. Piefer, R. F. Radel, T. E. Radel, and A. L. Wehmeyer, Fusion Sci. Technol. 47, 1238 (2005)]. The TOF diagnostic detects the products of D(d,p)T reactions and determines where along a chord through the device the fusion event occurred. The diagnostic is also capable of using charged particle spectroscopy to determine the Doppler shift imparted to the fusion products by the center of mass energy of the fusion reactants. The TOF diagnostic is thus able to collect spatial profiles of the fusion reaction density along a chord through the device, coupled with the center of mass energy of the reactions occurring at each location. This provides levels of diagnostic detail never before achieved on an IEC device.« less

Morphometric MRI Imaging Study of the Corridor for the Oblique Lumbar Interbody Fusion Technique at L1-L5.

PubMed

Julian Li, Jia Xi; Mobbs, Ralph J; Phan, Kevin

2018-03-01

Anterior lumbar interbody fusion and lateral lumbar interbody fusion are associated with approach-related disadvantages. Oblique lumbar interbody fusion (OLIF) is the proposed solution, especially for upper lumbar levels. We analyzed the size and regional anatomy of the corridor used in the OLIF technique between levels L1 and L5. This is a morphometric study of 200 randomly selected magnetic resonance imaging (MRI) studies with features of lumbar degenerative disease. On MRI, the oblique corridor was defined as the smallest distance between the psoas major muscle and aorta or inferior vena cava (or common iliac artery) and measured at the L1/L2, L2/L3, L3/L4, and L4/L5 disc levels on both the left and right on the axial images at the mid-disc level. Mean distances of the oblique corridor on the left side were L1/L2 = 18.90 mm, L2/L3 = 15.50 mm; L3/L4 = 12.75 mm, and L4/L5 = 8.92 mm; on the right side, they were L1/L2 = 14.80 mm, L2/L3 = 5.50 mm, L3/L4 = 3.00 mm, and L4/L5 = 1.46 mm. For both sides, the corridor size was not significantly affected by sex, and it increased with age and decreased at the inferior lumbar disc levels. The L1/L2 and L2/L3 levels may be obstructed by the ipsilateral kidney and renal vasculature on both sides and the liver on the right side. A left-sided OLIF approach is viable for both sexes. Oblique access to the L1/L2 and L2/L3 disc levels is feasible regardless of age, whereas the L3/L4 and L4/L5 levels may be more suitable in older patients, especially for male patients. The right-sided approach is less likely to be performed effectively. Copyright © 2018 Elsevier Inc. All rights reserved.

Infrared and visible image fusion using discrete cosine transform and swarm intelligence for surveillance applications

NASA Astrophysics Data System (ADS)

Paramanandham, Nirmala; Rajendiran, Kishore

2018-01-01

A novel image fusion technique is presented for integrating infrared and visible images. Integration of images from the same or various sensing modalities can deliver the required information that cannot be delivered by viewing the sensor outputs individually and consecutively. In this paper, a swarm intelligence based image fusion technique using discrete cosine transform (DCT) domain is proposed for surveillance application which integrates the infrared image with the visible image for generating a single informative fused image. Particle swarm optimization (PSO) is used in the fusion process for obtaining the optimized weighting factor. These optimized weighting factors are used for fusing the DCT coefficients of visible and infrared images. Inverse DCT is applied for obtaining the initial fused image. An enhanced fused image is obtained through adaptive histogram equalization for a better visual understanding and target detection. The proposed framework is evaluated using quantitative metrics such as standard deviation, spatial frequency, entropy and mean gradient. The experimental results demonstrate the outperformance of the proposed algorithm over many other state- of- the- art techniques reported in literature.

Spinal Fusion

MedlinePlus

... concept of fusion is similar to that of welding in industry. Spinal fusion surgery, however, does not ... bone taken from the patient has a long history of use and results in predictable healing. Autograft ...

Fault detection and multiclassifier fusion for unmanned aerial vehicles (UAVs)

NASA Astrophysics Data System (ADS)

Yan, Weizhong

2001-03-01

UAVs demand more accurate fault accommodation for their mission manager and vehicle control system in order to achieve a reliability level that is comparable to that of a pilot aircraft. This paper attempts to apply multi-classifier fusion techniques to achieve the necessary performance of the fault detection function for the Lockheed Martin Skunk Works (LMSW) UAV Mission Manager. Three different classifiers that meet the design requirements of the fault detection of the UAAV are employed. The binary decision outputs from the classifiers are then aggregated using three different classifier fusion schemes, namely, majority vote, weighted majority vote, and Naieve Bayes combination. All of the three schemes are simple and need no retraining. The three fusion schemes (except the majority vote that gives an average performance of the three classifiers) show the classification performance that is better than or equal to that of the best individual. The unavoidable correlation between the classifiers with binary outputs is observed in this study. We conclude that it is the correlation between the classifiers that limits the fusion schemes to achieve an even better performance.

A robust vision-based sensor fusion approach for real-time pose estimation.

PubMed

Assa, Akbar; Janabi-Sharifi, Farrokh

2014-02-01

Object pose estimation is of great importance to many applications, such as augmented reality, localization and mapping, motion capture, and visual servoing. Although many approaches based on a monocular camera have been proposed, only a few works have concentrated on applying multicamera sensor fusion techniques to pose estimation. Higher accuracy and enhanced robustness toward sensor defects or failures are some of the advantages of these schemes. This paper presents a new Kalman-based sensor fusion approach for pose estimation that offers higher accuracy and precision, and is robust to camera motion and image occlusion, compared to its predecessors. Extensive experiments are conducted to validate the superiority of this fusion method over currently employed vision-based pose estimation algorithms.

Review of fusion synfuels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fillo, J.A.

1980-01-01

Thermonuclear fusion offers an inexhaustible source of energy for the production of hydrogen from water. Depending on design, electric generation efficiencies of approx. 40 to 60% and hydrogen production efficiencies by high-temperature electrolysis of approx. 50 to 65% are projected for fusion reactors using high-temperatures blankets. Fusion/coal symbiotic systems appear economically promising for the first generation of commercial fusion synfuels plants. Coal production requirements and the environmental effects of large-scale coal usage would be greatly reduced by a fusion/coal system. In the long term, there could be a gradual transition to an inexhaustible energy system based solely on fusion.

Application of Magnetized Target Fusion to High-Energy Space Propulsion

NASA Technical Reports Server (NTRS)

Thio, Y. C. F.; Schmidt, G. R.; Kirkpatrick, R. C.; Rodgers, Stephen L. (Technical Monitor)

2001-01-01

Most fusion propulsion concepts that have been investigated in the past employ some form of inertial or magnetic confinement. Although the prospective performance of these concepts is excellent, the fusion processes on which these concepts are based still require considerable development before they can be seriously considered for actual applications. Furthermore, these processes are encumbered by the need for sophisticated plasma and power handling systems that are generally quite inefficient and have historically resulted in large, massive spacecraft designs. Here we present a comparatively new approach, Magnetized Target Fusion (MTF), which offers a nearer-term avenue for realizing the tremendous performance benefits of fusion propulsion'. The key advantage of MTF is its less demanding requirements for driver energy and power processing. Additional features include: 1) very low system masses and volumes, 2) high gain and relatively low waste heat, 3) substantial utilization of energy from product neutrons, 4) efficient, low peak-power drivers based on existing pulsed power technology, and 5) very high Isp, specific power and thrust. MTF overcomes many of the problems associated with traditional fusion techniques, thus making it particularly attractive for space applications. Isp greater than 50,000 seconds and specific powers greater than 50 kilowatts/kilogram appear feasible using relatively near-term pulse power and plasma gun technology.

Image Fusion of CT and MR with Sparse Representation in NSST Domain

PubMed Central

Qiu, Chenhui; Wang, Yuanyuan; Zhang, Huan

2017-01-01

Multimodal image fusion techniques can integrate the information from different medical images to get an informative image that is more suitable for joint diagnosis, preoperative planning, intraoperative guidance, and interventional treatment. Fusing images of CT and different MR modalities are studied in this paper. Firstly, the CT and MR images are both transformed to nonsubsampled shearlet transform (NSST) domain. So the low-frequency components and high-frequency components are obtained. Then the high-frequency components are merged using the absolute-maximum rule, while the low-frequency components are merged by a sparse representation- (SR-) based approach. And the dynamic group sparsity recovery (DGSR) algorithm is proposed to improve the performance of the SR-based approach. Finally, the fused image is obtained by performing the inverse NSST on the merged components. The proposed fusion method is tested on a number of clinical CT and MR images and compared with several popular image fusion methods. The experimental results demonstrate that the proposed fusion method can provide better fusion results in terms of subjective quality and objective evaluation. PMID:29250134

Image Fusion of CT and MR with Sparse Representation in NSST Domain.

PubMed

Qiu, Chenhui; Wang, Yuanyuan; Zhang, Huan; Xia, Shunren

2017-01-01

Multimodal image fusion techniques can integrate the information from different medical images to get an informative image that is more suitable for joint diagnosis, preoperative planning, intraoperative guidance, and interventional treatment. Fusing images of CT and different MR modalities are studied in this paper. Firstly, the CT and MR images are both transformed to nonsubsampled shearlet transform (NSST) domain. So the low-frequency components and high-frequency components are obtained. Then the high-frequency components are merged using the absolute-maximum rule, while the low-frequency components are merged by a sparse representation- (SR-) based approach. And the dynamic group sparsity recovery (DGSR) algorithm is proposed to improve the performance of the SR-based approach. Finally, the fused image is obtained by performing the inverse NSST on the merged components. The proposed fusion method is tested on a number of clinical CT and MR images and compared with several popular image fusion methods. The experimental results demonstrate that the proposed fusion method can provide better fusion results in terms of subjective quality and objective evaluation.

A method based on IHS cylindrical transform model for quality assessment of image fusion

NASA Astrophysics Data System (ADS)

Zhu, Xiaokun; Jia, Yonghong

2005-10-01

Image fusion technique has been widely applied to remote sensing image analysis and processing, and methods for quality assessment of image fusion in remote sensing have also become the research issues at home and abroad. Traditional assessment methods combine calculation of quantitative indexes and visual interpretation to compare fused images quantificationally and qualitatively. However, in the existing assessment methods, there are two defects: on one hand, most imdexes lack the theoretic support to compare different fusion methods. On the hand, there is not a uniform preference for most of the quantitative assessment indexes when they are applied to estimate the fusion effects. That is, the spatial resolution and spectral feature could not be analyzed synchronously by these indexes and there is not a general method to unify the spatial and spectral feature assessment. So in this paper, on the basis of the approximate general model of four traditional fusion methods, including Intensity Hue Saturation(IHS) triangle transform fusion, High Pass Filter(HPF) fusion, Principal Component Analysis(PCA) fusion, Wavelet Transform(WT) fusion, a correlation coefficient assessment method based on IHS cylindrical transform is proposed. By experiments, this method can not only get the evaluation results of spatial and spectral features on the basis of uniform preference, but also can acquire the comparison between fusion image sources and fused images, and acquire differences among fusion methods. Compared with the traditional assessment methods, the new methods is more intuitionistic, and in accord with subjective estimation.

Magneto-Inertial Fusion

DOE PAGES

Wurden, G. A.; Hsu, S. C.; Intrator, T. P.; ...

2015-11-17

In this community white paper, we describe an approach to achieving fusion which employs a hybrid of elements from the traditional magnetic and inertial fusion concepts, called magneto-inertial fusion (MIF). Furthermore, the status of MIF research in North America at multiple institutions is summarized including recent progress, research opportunities, and future plans.

Atlantoaxial Fusion Using C1 Sublaminar Cables and C2 Translaminar Screws.

PubMed

Larsen, Alexandra M Giantini; Grannan, Benjamin L; Koffie, Robert M; Coumans, Jean-Valéry

2018-06-01

Atlantoaxial instability, which can arise in the setting of trauma, degenerative diseases, and neoplasm, is often managed surgically with C1-C2 arthrodesis. Classical C1-C2 fusion techniques require placement of instrumentation in close proximity to the vertebral artery and C2 nerve root. To report a novel C1-C2 fusion technique that utilizes C2 translaminar screws and C1 sublaminar cables to decrease the risk of injury to the vertebral artery and C2 nerve root. To facilitate fixation to the atlas, while minimizing the risk of injury to the vertebral artery and to the C2 nerve root, we sought to determine the feasibility of using a soft cable around the C1 arch and affixing it to a rod connected to C2 laminar screws. We reviewed our experience in 3 patients. We used this technique in patients in whom we anticipated difficult C1 screw placement. Three patients were identified through a review of the senior author's cases. Atlantoaxial instability was associated with trauma in 2 patients and chronic degenerative changes in 1 patient. Common symptoms on presentation included pain and limited range of motion. All patients underwent C1-C2 fusion with C2 translaminar screws with sublaminar cable harnessing of the posterior arch of C1. There were no reports of postoperative complications or hardware failure. We demonstrate a novel, technically straightforward approach for C1-C2 fusion that minimizes risk to the vertebral artery and to the C2 nerve root, while still allowing for semirigid fixation in instances of both traumatic and chronic degenerative atlantoaxial instability.

Membrane fusion and exocytosis.

PubMed

Jahn, R; Südhof, T C

1999-01-01

Membrane fusion involves the merger of two phospholipid bilayers in an aqueous environment. In artificial lipid bilayers, fusion proceeds by means of defined transition states, including hourglass-shaped intermediates in which the proximal leaflets of the fusing membranes are merged whereas the distal leaflets are separate (fusion stalk), followed by the reversible opening of small aqueous fusion pores. Fusion of biological membranes requires the action of specific fusion proteins. Best understood are the viral fusion proteins that are responsible for merging the viral with the host cell membrane during infection. These proteins undergo spontaneous and dramatic conformational changes upon activation. In the case of the paradigmatic fusion proteins of the influenza virus and of the human immunodeficiency virus, an amphiphilic fusion peptide is inserted into the target membrane. The protein then reorients itself, thus forcing the fusing membranes together and inducing lipid mixing. Fusion of intracellular membranes in eukaryotic cells involves several protein families including SNAREs, Rab proteins, and Sec1/Munc-18 related proteins (SM-proteins). SNAREs form a novel superfamily of small and mostly membrane-anchored proteins that share a common motif of about 60 amino acids (SNARE motif). SNAREs reversibly assemble into tightly packed helical bundles, the core complexes. Assembly is thought to pull the fusing membranes closely together, thus inducing fusion. SM-proteins comprise a family of soluble proteins that bind to certain types of SNAREs and prevent the formation of core complexes. Rab proteins are GTPases that undergo highly regulated GTP-GDP cycles. In their GTP form, they interact with specific proteins, the effector proteins. Recent evidence suggests that Rab proteins function in the initial membrane contact connecting the fusing membranes but are not involved in the fusion reaction itself.

A Proposed Data Fusion Architecture for Micro-Zone Analysis and Data Mining

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kevin McCarthy; Milos Manic

Data Fusion requires the ability to combine or “fuse” date from multiple data sources. Time Series Analysis is a data mining technique used to predict future values from a data set based upon past values. Unlike other data mining techniques, however, Time Series places special emphasis on periodicity and how seasonal and other time-based factors tend to affect trends over time. One of the difficulties encountered in developing generic time series techniques is the wide variability of the data sets available for analysis. This presents challenges all the way from the data gathering stage to results presentation. This paper presentsmore » an architecture designed and used to facilitate the collection of disparate data sets well suited to Time Series analysis as well as other predictive data mining techniques. Results show this architecture provides a flexible, dynamic framework for the capture and storage of a myriad of dissimilar data sets and can serve as a foundation from which to build a complete data fusion architecture.« less

Morphological filtering and multiresolution fusion for mammographic microcalcification detection

NASA Astrophysics Data System (ADS)

Chen, Lulin; Chen, Chang W.; Parker, Kevin J.

1997-04-01

Mammographic images are often of relatively low contrast and poor sharpness with non-stationary background or clutter and are usually corrupted by noise. In this paper, we propose a new method for microcalcification detection using gray scale morphological filtering followed by multiresolution fusion and present a unified general filtering form called the local operating transformation for whitening filtering and adaptive thresholding. The gray scale morphological filters are used to remove all large areas that are considered as non-stationary background or clutter variations, i.e., to prewhiten images. The multiresolution fusion decision is based on matched filter theory. In addition to the normal matched filter, the Laplacian matched filter which is directly related through the wavelet transforms to multiresolution analysis is exploited for microcalcification feature detection. At the multiresolution fusion stage, the region growing techniques are used in each resolution level. The parent-child relations between resolution levels are adopted to make final detection decision. FROC is computed from test on the Nijmegen database.

Influence of surgical experience on the efficiency of discectomy in TLIF: a cadaveric testing in 40 levels.

PubMed

Pumberger, Matthias; Hughes, Alexander P; Girardi, Federico P; Gogia, Jaspaul; Kotwal, Suhel Y; Thaler, Christoph; Sama, Andrew A

2012-12-01

Cadaveric study. The purpose of this study was to assess the influence of surgical experience on the efficiency of lumbar discectomy in open transforaminal lumbar interbody fusion. There is limited knowledge about the efficiency of discectomy among surgeons. As a first study, we are evaluating the effect of surgical experience on it. Manual and powered discectomies were randomized and performed by 3 attending spine surgeons and 2 clinical spine fellows. Each discectomy procedure was analyzed for the area of complete endplate preparation, total elapsed time, and number of instrument passes. The surface area of discectomy at each endplate was measured utilizing digital imaging and the appropriate software. For the purpose of the analysis, the superior and the inferior endplates were divided into ipsilateral and contralateral halves, and each half was further divided into ventral and dorsal quadrants. Each quadrant was analyzed in a blinded manner by 2 observers. A total of 40 discectomies were performed on 9 fresh-frozen cadaveric torsos between the levels T12 and S1. A powered discectomy device was used in levels 9 and 11 by the attendings. Manual discectomy was performed in 11 levels by the spine fellows and 9 by the spine attendings. No significant difference was observed between the spine fellows and spine attendings when the manual instruments were used (P = 0.924). However, the spine attending surgeon group had a significantly increased total area of discectomy compared with the fellows (P = 0.003). No significant difference was observed between the groups when instrument passes or the total elapsed time were compared either utilizing the manual or the powered technique. Our results demonstrate that a satisfactory discectomy may be performed by surgeons with relatively less surgical experience in the transforaminal approach using a powered discectomy device.

Review of the magnetic fusion program by the 1986 ERAB Fusion Panel

NASA Astrophysics Data System (ADS)

Davidson, Ronald C.

1987-09-01

The 1986 ERAB Fusion Panel finds that fusion energy continues to be an attractive energy source with great potential for the future, and that the magnetic fusion program continues to make substantial technical progress. In addition, fusion research advances plasma physics, a sophisticated and useful branch of applied science, as well as technologies important to industry and defense. These factors fully justify the substantial expenditures by the Department of Energy in fusion research and development (R&D). The Panel endorses the overall program direction, strategy, and plans, and recognizes the importance and timeliness of proceeding with a burning plasma experiment, such as the proposed Compact Ignition Tokamak (CIT) experiment.

Double Cluster Heads Model for Secure and Accurate Data Fusion in Wireless Sensor Networks

PubMed Central

Fu, Jun-Song; Liu, Yun

2015-01-01

Secure and accurate data fusion is an important issue in wireless sensor networks (WSNs) and has been extensively researched in the literature. In this paper, by combining clustering techniques, reputation and trust systems, and data fusion algorithms, we propose a novel cluster-based data fusion model called Double Cluster Heads Model (DCHM) for secure and accurate data fusion in WSNs. Different from traditional clustering models in WSNs, two cluster heads are selected after clustering for each cluster based on the reputation and trust system and they perform data fusion independently of each other. Then, the results are sent to the base station where the dissimilarity coefficient is computed. If the dissimilarity coefficient of the two data fusion results exceeds the threshold preset by the users, the cluster heads will be added to blacklist, and the cluster heads must be reelected by the sensor nodes in a cluster. Meanwhile, feedback is sent from the base station to the reputation and trust system, which can help us to identify and delete the compromised sensor nodes in time. Through a series of extensive simulations, we found that the DCHM performed very well in data fusion security and accuracy. PMID:25608211

Overview of the US Fusion Materials Sciences Program

NASA Astrophysics Data System (ADS)

Zinkle, Steven

2004-11-01

The challenging fusion reactor environment (radiation, heat flux, chemical compatibility, thermo-mechanical stresses) requires utilization of advanced materials to fulfill the promise of fusion to provide safe, economical, and environmentally acceptable energy. This presentation reviews recent experimental and modeling highlights on structural materials for fusion energy. The materials requirements for fusion will be compared with other demanding technologies, including high temperature turbine components, proposed Generation IV fission reactors, and the current NASA space fission reactor project to explore the icy moons of Jupiter. A series of high-performance structural materials have been developed by fusion scientists over the past ten years with significantly improved properties compared to earlier materials. Recent advances in the development of high-performance ferritic/martensitic and bainitic steels, nanocomposited oxide dispersion strengthened ferritic steels, high-strength V alloys, improved-ductility Mo alloys, and radiation-resistant SiC composites will be reviewed. Multiscale modeling is providing important insight on radiation damage and plastic deformation mechanisms and fracture mechanics behavior. Electron microscope in-situ straining experiments are uncovering fundamental physical processes controlling deformation in irradiated metals. Fundamental modeling and experimental studies are determining the behavior of transmutant helium in metals, enabling design of materials with improved resistance to void swelling and helium embrittlement. Recent chemical compatibility tests have identified promising new candidates for magnetohydrodynamic insulators in lithium-cooled systems, and have established the basic compatibility of SiC with Pb-Li up to high temperature. Research on advanced joining techniques such as friction stir welding will be described. ITER materials research will be briefly summarized.

Thick Nano-Crystalline Diamond films for fusion applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dawedeit, Christoph

This Diplomarbeit deals with the characterization of 9 differently grown diamond samples. Several techniques were used to determine the quality of these specimens for inertial confinement fusion targets. The quality of chemical vapor deposition diamond is usually considered in terms of the proportion of sp3-bonded carbon to sp2-bonded carbon in the sample. For fusion targets smoothness, Hydrogen content and density of the diamonds are further important characteristics. These characteristics are analyzed in this thesis. The research for thesis was done at Lawrence Livermore National Laboratory in collaboration with the Fraunhofer Institut für angewandte Festkörperphysik Freiburg, Germany. Additionally the Lehrstuhl fuermore » Nukleartechnik at Technical University of Germany supported the work.« less

The actin cytoskeleton inhibits pore expansion during PIV5 fusion protein-promoted cell-cell fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wurth, Mark A.; Schowalter, Rachel M.; Smith, Everett Clinton

2010-08-15

Paramyxovirus fusion (F) proteins promote both virus-cell fusion, required for viral entry, and cell-cell fusion, resulting in syncytia formation. We used the F-actin stabilizing drug, jasplakinolide, and the G-actin sequestrant, latrunculin A, to examine the role of actin dynamics in cell-cell fusion mediated by the parainfluenza virus 5 (PIV5) F protein. Jasplakinolide treatment caused a dose-dependent increase in cell-cell fusion as measured by both syncytia and reporter gene assays, and latrunculin A treatment also resulted in fusion stimulation. Treatment with jasplakinolide or latrunculin A partially rescued a fusion pore opening defect caused by deletion of the PIV5 F protein cytoplasmicmore » tail, but these drugs had no effect on fusion inhibited at earlier stages by either temperature arrest or by a PIV5 heptad repeat peptide. These data suggest that the cortical actin cytoskeleton is an important regulator of fusion pore enlargement, an energetically costly stage of viral fusion protein-mediated membrane merger.« less

The actin cytoskeleton inhibits pore expansion during PIV5 fusion protein-promoted cell-cell fusion

PubMed Central

Wurth, Mark A.; Schowalter, Rachel M.; Smith, Everett Clinton; Moncman, Carole L.; Dutch, Rebecca Ellis; McCann, Richard O.

2010-01-01

Paramyxovirus fusion (F) proteins promote both virus-cell fusion, required for viral entry, and cell-cell fusion, resulting in syncytia formation. We used the F-actin stabilizing drug, jasplakinolide, and the G-actin sequestrant, latrunculin A, to examine the role of actin dynamics in cell-cell fusion mediated by the parainfluenza virus 5 (PIV5) F protein. Jasplakinolide treatment caused a dose-dependent increase in cell-cell fusion as measured by both syncytia and reporter gene assays, and latrunculin A treatment also resulted in fusion stimulation. Treatment with jasplakinolide or latrunculin A partially rescued a fusion pore opening defect caused by deletion of the PIV5 F protein cytoplasmic tail, but these drugs had no effect on fusion inhibited at earlier stages by either temperature arrest or by a PIV5 heptad repeat peptide. These data suggest that the cortical actin cytoskeleton is an important regulator of fusion pore enlargement, an energetically costly stage of viral fusion protein-mediated membrane merger. PMID:20537366

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.

Decision-Level Fusion of Spatially Scattered Multi-Modal Data for Nondestructive Inspection of Surface Defects

PubMed Central

Heideklang, René; Shokouhi, Parisa

2016-01-01

This article focuses on the fusion of flaw indications from multi-sensor nondestructive materials testing. Because each testing method makes use of a different physical principle, a multi-method approach has the potential of effectively differentiating actual defect indications from the many false alarms, thus enhancing detection reliability. In this study, we propose a new technique for aggregating scattered two- or three-dimensional sensory data. Using a density-based approach, the proposed method explicitly addresses localization uncertainties such as registration errors. This feature marks one of the major of advantages of this approach over pixel-based image fusion techniques. We provide guidelines on how to set all the key parameters and demonstrate the technique’s robustness. Finally, we apply our fusion approach to experimental data and demonstrate its capability to locate small defects by substantially reducing false alarms under conditions where no single-sensor method is adequate. PMID:26784200

Tumor or abnormality identification from magnetic resonance images using statistical region fusion based segmentation.

PubMed

Subudhi, Badri Narayan; Thangaraj, Veerakumar; Sankaralingam, Esakkirajan; Ghosh, Ashish

2016-11-01

In this article, a statistical fusion based segmentation technique is proposed to identify different abnormality in magnetic resonance images (MRI). The proposed scheme follows seed selection, region growing-merging and fusion of multiple image segments. In this process initially, an image is divided into a number of blocks and for each block we compute the phase component of the Fourier transform. The phase component of each block reflects the gray level variation among the block but contains a large correlation among them. Hence a singular value decomposition (SVD) technique is adhered to generate a singular value of each block. Then a thresholding procedure is applied on these singular values to identify edgy and smooth regions and some seed points are selected for segmentation. By considering each seed point we perform a binary segmentation of the complete MRI and hence with all seed points we get an equal number of binary images. A parcel based statistical fusion process is used to fuse all the binary images into multiple segments. Effectiveness of the proposed scheme is tested on identifying different abnormalities: prostatic carcinoma detection, tuberculous granulomas identification and intracranial neoplasm or brain tumor detection. The proposed technique is established by comparing its results against seven state-of-the-art techniques with six performance evaluation measures. Copyright © 2016 Elsevier Inc. All rights reserved.

Ontological Issues in Higher Levels of Information Fusion: User Refinement of the Fusion Process

DTIC Science & Technology

2003-01-01

fusion question, the thing that is separates the Greek We explore the higher-level purpose offusion systems by philosophical questions and modem day...the The Greeks focused on both data fusion and the Fusion02 conference there are common fusion questions philosophical questions of an ontology - the...data World of Visible Things Belief (pistis) fusion - user refinement. The rest of the paper is as Appearances follows: Section 2 details the Greek

Distinct Requirements for HIV-Cell Fusion and HIV-mediated Cell-Cell Fusion*

PubMed Central

Kondo, Naoyuki; Marin, Mariana; Kim, Jeong Hwa; Desai, Tanay M.; Melikyan, Gregory B.

2015-01-01

Whether HIV-1 enters cells by fusing with the plasma membrane or with endosomes is a subject of active debate. The ability of HIV-1 to mediate fusion between adjacent cells, a process referred to as “fusion-from-without” (FFWO), shows that this virus can fuse with the plasma membrane. To compare FFWO occurring at the cell surface with HIV-cell fusion through a conventional entry route, we designed an experimental approach that enabled the measurements of both processes in the same sample. The following key differences were observed. First, a very small fraction of viruses fusing with target cells participated in FFWO. Second, whereas HIV-1 fusion with adherent cells was insensitive to actin inhibitors, post-CD4/coreceptor binding steps during FFWO were abrogated. A partial dependence of HIV-cell fusion on actin remodeling was observed in CD4+ T cells, but this effect appeared to be due to the actin dependence of virus uptake. Third, deletion of the cytoplasmic tail of HIV-1 gp41 dramatically enhanced the ability of the virus to promote FFWO, while having a modest effect on virus-cell fusion. Distinct efficiencies and actin dependences of FFWO versus HIV-cell fusion are consistent with the notion that, except for a minor fraction of particles that mediate fusion between the plasma membranes of adjacent cells, HIV-1 enters through an endocytic pathway. We surmise, however, that cell-cell contacts enabling HIV-1 fusion with the plasma membrane could be favored at the sites of high density of target cells, such as lymph nodes. PMID:25589785

Fusion of High Resolution Multispectral Imagery in Vulnerable Coastal and Land Ecosystems.

PubMed

Ibarrola-Ulzurrun, Edurne; Gonzalo-Martin, Consuelo; Marcello-Ruiz, Javier; Garcia-Pedrero, Angel; Rodriguez-Esparragon, Dionisio

2017-01-25

Ecosystems provide a wide variety of useful resources that enhance human welfare, but these resources are declining due to climate change and anthropogenic pressure. In this work, three vulnerable ecosystems, including shrublands, coastal areas with dunes systems and areas of shallow water, are studied. As far as these resources' reduction is concerned, remote sensing and image processing techniques could contribute to the management of these natural resources in a practical and cost-effective way, although some improvements are needed for obtaining a higher quality of the information available. An important quality improvement is the fusion at the pixel level. Hence, the objective of this work is to assess which pansharpening technique provides the best fused image for the different types of ecosystems. After a preliminary evaluation of twelve classic and novel fusion algorithms, a total of four pansharpening algorithms was analyzed using six quality indices. The quality assessment was implemented not only for the whole set of multispectral bands, but also for the subset of spectral bands covered by the wavelength range of the panchromatic image and outside of it. A better quality result is observed in the fused image using only the bands covered by the panchromatic band range. It is important to highlight the use of these techniques not only in land and urban areas, but a novel analysis in areas of shallow water ecosystems. Although the algorithms do not show a high difference in land and coastal areas, coastal ecosystems require simpler algorithms, such as fast intensity hue saturation, whereas more heterogeneous ecosystems need advanced algorithms, as weighted wavelet ' à trous ' through fractal dimension maps for shrublands and mixed ecosystems. Moreover, quality map analysis was carried out in order to study the fusion result in each band at the local level. Finally, to demonstrate the performance of these pansharpening techniques, advanced Object

Significant Improvement of Puncture Accuracy and Fluoroscopy Reduction in Percutaneous Transforaminal Endoscopic Discectomy With Novel Lumbar Location System: Preliminary Report of Prospective Hello Study.

PubMed

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

2015-12-01

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 times, 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 times 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 = 0.002). The

Circumferential Fusion through All-Posterior Approach in Andersson Lesion

PubMed Central

Rajoli, Sreekanth Reddy; Kanna, Rishi Mugesh; Aiyer, Siddharth N.; Shetty, Ajoy Prasad

2017-01-01

Study Design Retrospective case series. Purpose To assess safety and efficacy of single stage, posterior stabilisation and anterior cage reconstruction through the transforaminal or lateral extra-cavitary route for Andersson lesions. Overview of Literature Pseudoarthrosis in ankylosing spondylitis (Andersson lesion, AL) can cause progressive kyphosis and neurological deficit. Management involves early recognition and surgical stabilisation in patients with instability. However, the need and safety of anterior reconstruction of the vertebral body defect remains unclear. Methods Twenty consecutive patients with AL whom presented with instability back pain and or neurological deficit were managed by single stage posterior approach with long segment pedicle screw fixation and anterior vertebral reconstruction. Radiological evaluation included- the regional kyphotic angle, measurement of anterior defect in computed tomography (CT) scan and the spinal cord status in magnetic resonance imaging. Radiological outcomes were assessed for fusion and kyphosis correction. Functional outcomes were assessed with visual analogue scale (VAS), ankylosing spondylitis quality of life (ASQoL) and Oswestry disability index (ODI). Results The mean age of the patients was 50.1 years (male, 18; female, 2). The levels affected include thoracolumbar (n=12), lower thoracic (n=5) and lumbar (n=3) regions. The mean level of fixation was 6.2±2.4 vertebrae. The mean anterior column defect was 1.6±0.6 cm. The mean surgical duration, blood loss and hospital stay were 112 minutes, 452 mL and 6.2 days, respectively. The mean followup was 2.1 years. At final follow up, VAS for back pain improved from 8.2 to 2.4 while ODI improved from 62.7 to 18.5 (p <0.05) and ASQoL improved from 14.3±2.08 to 7.90±1.48 (p <0.05). All patients had achieved radiological union at a mean 7.2±4.6 months. The mean regional kyphotic angle was 27° preoperatively, 16.7° postoperatively and 18.1° at the final follow

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.

[Axial lumbar interbody fusion: prospective monocentric study].

PubMed

Stulík, J; Adámek, S; Barna, M; Kaspříková, N; Polanecký, O; Kryl, J

2014-01-01

The aim of this prospective study was to evaluate clinical and radiographic results in the patients who underwent L5-S1 fixation using the technique of percutaneous lumbar interbody fusion (AxiaLIF). The study comprised 23 patients, 11 women and 12 men, who ranged from age of 21 to 63 years, with an average of 48.2 years. In all patients surgical posterior stabilisation involving the L5-S1 segment had previously been done. The initial indications for surgery were L5-S1 spondylolisthesis in 20 and L5-S1 spondylosis and stenosis in three patients. The AxiaLIF technique for L5-S1 fixation was indicated in overweight patients and in those after repeated abdominal or retroperitoneal surgery. A suitable position and shape of the sacrum or lumbosacral junction was another criterion. The patients were evaluated between 26 and 56 months (average, 40.4 months) after primary surgery and, on the basis of CT and radiographic findings, bone union and lumbosacral junction stability were assessed. The clinical outcome was investigated using the ODI and VAS systems and the results were statistically analysed by the Wilcoxon test for paired samples with statistical significance set at a level of 0.05. The average VAS value was 6.6 before surgery and, after surgery, 5.2 at three months, 4.2 at six months, 3.1 at one year, 2.9 at two years and 2.1 at three years (n=18). At two post-operative years, improvement in the VAS value by 56.1% was recorded. The average pre-operative ODI value was 25.1; the post-operative values were 17.0 at six months, 12.3 at one year, 10.6 at two years and 8.2 at three years (n=18). At two years after surgery the ODI value improved by 57.8%. To the question concerning their willingness to undergo, with acquired experience, surgery for the same diagnosis, 21 patients (91.3%) gave an affirmative answer. Neither screw breakage nor neurovascular damage or rectal injury was found. CT scans showed complete interbody bone fusion in 22 of the 23 patients (95

Influence of incomplete fusion on complete fusion at energies above the Coulomb barrier

NASA Astrophysics Data System (ADS)

Shuaib, Mohd; Sharma, Vijay R.; Yadav, Abhishek; Sharma, Manoj Kumar; Singh, Pushpendra P.; Singh, Devendra P.; Kumar, R.; Singh, R. P.; Muralithar, S.; Singh, B. P.; Prasad, R.

2017-10-01

In the present work, excitation functions of several reaction residues in the system 19F+169Tm, populated via the complete and incomplete fusion processes, have been measured using off-line γ-ray spectroscopy. The analysis of excitation functions has been done within the framework of statistical model code pace4. The excitation functions of residues populated via xn and pxn channels are found to be in good agreement with those estimated by the theoretical model code, which confirms the production of these residues solely via complete fusion process. However, a significant enhancement has been observed in the cross-sections of residues involving α-emitting channels as compared to the theoretical predictions. The observed enhancement in the cross-sections has been attributed to the incomplete fusion processes. In order to have a better insight into the onset and strength of incomplete fusion, the incomplete fusion strength function has been deduced. At present, there is no theoretical model available which can satisfactorily explain the incomplete fusion reaction data at energies ≈4-6 MeV/nucleon. In the present work, the influence of incomplete fusion on complete fusion in the 19F+169Tm system has also been studied. The measured cross-section data may be important for the development of reactor technology as well. It has been found that the incomplete fusion strength function strongly depends on the α-Q value of the projectile, which is found to be in good agreement with the existing literature data. The analysis strongly supports the projectile-dependent mass-asymmetry systematics. In order to study the influence of Coulomb effect ({Z}{{P}}{Z}{{T}}) on incomplete fusion, the deduced strength function for the present work is compared with the nearby projectile-target combinations. The incomplete fusion strength function is found to increase linearly with {Z}{{P}}{Z}{{T}}, indicating a strong influence of Coulomb effect in the incomplete fusion reactions.

Cluster-impact fusion, or beam-contaminant fusion? (abstract)a),b)

NASA Astrophysics Data System (ADS)

Lo, Daniel H.; Petrasso, Richard D.; Wenzel, Kevin W.

1992-10-01

Beuhler, Friedlander, and Friedman (BFF) reported anomalously huge D-D fusion rates while bombarding deuterated targets with (D2O)N+ clusters (N˜25-1000) accelerated to ≊325 keV [R. J. Beuhler et al., Phys. Rev. Lett. 63, 1292 (1989); R. J. Beuhler et al., J. Phys. Chem. 94, 7665 (1990)] [i.e., ≊0.3 keV lab energy for D in (D2O)100+]. However, from our analysis of BFF's fusion product spectra, we conclude that their D lab energy was ˜50 keV. Therefore, no gross anomalies exist. Also, from our analysis of the BFF beam-ranging experiments through 500 μg/cm2 of Au, we conclude that light-ion-beam contaminants (e.g., D+ of order 100 keV) have not been ruled out, and are the probable cause of their fusion reactions. This work was supported by LLNL Subcontract B116798, Department of Energy (DOE) Grant No. DE-FG02-91ER54109, DOE Magnetic Fusion Energy Technology Fellowship Program (D. H. Lo), and DOE Fusion Energy Postdoctoral Research Program (Kevin W. Wenzel).

Failure of technetium bone scanning to detect pseudarthroses in spinal fusion for scoliosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hannon, K.M.; Wetta, W.J.

1977-01-01

A prospective study of 11 patients suggests that present techniques of technetium bone scanning do not assist in recognizing the presence of well-established pseudarthrosis in spinal fusions for scoliosis.

SVM-based multi-sensor fusion for free-living physical activity assessment.

PubMed

Liu, Shaopeng; Gao, Robert X; John, Dinesh; Staudenmayer, John; Freedson, Patty S

2011-01-01

This paper presents a sensor fusion method for assessing physical activity (PA) of human subjects, based on the support vector machines (SVMs). Specifically, acceleration and ventilation measured by a wearable multi-sensor device on 50 test subjects performing 13 types of activities of varying intensities are analyzed, from which the activity types and related energy expenditures are derived. The result shows that the method correctly recognized the 13 activity types 84.7% of the time, which is 26% higher than using a hip accelerometer alone. Also, the method predicted the associated energy expenditure with a root mean square error of 0.43 METs, 43% lower than using a hip accelerometer alone. Furthermore, the fusion method was effective in reducing the subject-to-subject variability (standard deviation of recognition accuracies across subjects) in activity recognition, especially when data from the ventilation sensor was added to the fusion model. These results demonstrate that the multi-sensor fusion technique presented is more effective in assessing activities of varying intensities than the traditional accelerometer-alone based methods.

Fusion Science Education Outreach

NASA Astrophysics Data System (ADS)

Danielson, C. A.; DIII-D Education Group

1996-11-01

This presentation will focus on education outreach activities at General Atomics that have been expanded to include the general population on science education with a focus on fusion energy. Outreach materials are distributed upon request both nationally and internationally. These materials include a notebook containing copies of DIII--D tour panels, fusion poster, new fusion energy video, new fusion energy brochure, and the electromagnetic spectrum curriculum. The 1996 Fusion Forum (held in the House Caucus Room) included a student/ teacher lunch with Energy Secretary Hazel O'Leary and a private visit to the Forum exhibits. The continuing partnership with Kearny High School includes lectures, job shadowing, internship, equipment donations and an award-winning electric car-racing program. Development of distribution by CD of the existing interactive fusion energy kiosk and a virtual reality tour of the DIII--D facility are underway. The DIII--D fusion education WWW site includes e-mail addresses to ``Ask the Wizard,'' and/or receive GA's outreach materials. Steve Rodecker, a local science teacher, aided by DIII--D fusion staff, won his second Tapestry Award; he also was named the ``1995 National Science Teacher of the Year'' and will be present to share his experiences with the DIII--D educational outreach program.

Fusion Studies in Japan

NASA Astrophysics Data System (ADS)

Ogawa, Yuichi

2016-05-01

A new strategic energy plan decided by the Japanese Cabinet in 2014 strongly supports the steady promotion of nuclear fusion development activities, including the ITER project and the Broader Approach activities from the long-term viewpoint. Atomic Energy Commission (AEC) in Japan formulated the Third Phase Basic Program so as to promote an experimental fusion reactor project. In 2005 AEC has reviewed this Program, and discussed on selection and concentration among many projects of fusion reactor development. In addition to the promotion of ITER project, advanced tokamak research by JT-60SA, helical plasma experiment by LHD, FIREX project in laser fusion research and fusion engineering by IFMIF were highly prioritized. Although the basic concept is quite different between tokamak, helical and laser fusion researches, there exist a lot of common features such as plasma physics on 3-D magnetic geometry, high power heat load on plasma facing component and so on. Therefore, a synergetic scenario on fusion reactor development among various plasma confinement concepts would be important.

Segregation and transmission of mitochondrial markers in fusion products of the asporogenous yeast Torulopsis glabrata.

PubMed

Sriprakash, K S; Batum, C

1981-09-01

Using a protoplast fusion technique we have been able to locate to the mitochondrial genome of the asporogenous yeast Torulopsis glabrata mutations conferring resistance to oligomycin, antimycin and diuron. When two strains differing in the size of their mtDNAs were fused the mitochondrial markers from the parent with the larger mtDNA (71-91) were transmitted predominantly among the fusion products. Both genetical and physical evidence support the occurrence of recombination in T. glabrata mitochondrial genome. Segregation of the mitochondrial genome appears to take place before the separation of the first bud from the fusion product.

Fusion Rate and Clinical Outcomes in Two-Level Posterior Lumbar Interbody Fusion.

PubMed

Aono, Hiroyuki; Takenaka, Shota; Nagamoto, Yukitaka; Tobimatsu, Hidekazu; Yamashita, Tomoya; Furuya, Masayuki; Iwasaki, Motoki

2018-04-01

Posterior lumbar interbody fusion (PLIF) has become a general surgical method for degenerative lumbar diseases. Although many reports have focused on single-level PLIF, few have focused on 2-level PLIF, and no report has covered the fusion status of 2-level PLIF. The purpose of this study is to investigate clinical outcomes and fusion for 2-level PLIF by using a combination of dynamic radiographs and multiplanar-reconstruction computed tomography scans. This study consisted of 48 consecutive patients who underwent 2-level PLIF for degenerative lumbar diseases. We assessed surgery duration, estimated blood loss, complications, clinical outcomes as measured by the Japanese Orthopaedic Association score, lumbar sagittal alignment as measured on standing lateral radiographs, and fusion status as measured by dynamic radiographs and multiplanar-reconstruction computed tomography. Patients were examined at a follow-up point of 4.8 ± 2.2 years after surgery. Thirty-eight patients who did not undergo lumbosacral fusion comprised the lumbolumbar group, and 10 patients who underwent lumbosacral fusion comprised the lumbosacral group. The mean Japanese Orthopaedic Association score improved from 12.1 to 22.4 points by the final follow-up examination. Sagittal alignment also was improved. All patients had fusion in the cranial level. Seven patients had nonunion in the caudal level, and the lumbosacral group (40%) had a significantly poorer fusion rate than the lumbolumbar group (97%) did. Surgical outcomes of 2-level PLIF were satisfactory. The fusion rate at both levels was 85%. All nonunion was observed at the caudal level and concentrated at L5-S level in L4-5-S PLIF. Copyright © 2018 Elsevier Inc. All rights reserved.

The risks of epidural and transforaminal steroid injections in the Spine: Commentary and a comprehensive review of the literature

PubMed Central

Epstein, Nancy E.

2013-01-01

Background: Multiple type of spinal injections, whether epidural/translaminar or transforaminal, facet injections, are offered to patients with/without surgical spinal lesions by pain management specialists (radiologists, physiatrists, and anesthesiologists). Although not approved by the Food and Drug Administration (FDA), injections are being performed with an increased frequency (160%), are typically short-acting and ineffective over the longer-term, while exposing patients to major risks/complications. Methods: For many patients with spinal pain alone and no surgical lesions, the “success” of epidural injections may simply reflect the self-limited course of the disease. Alternatively, although those with surgical pathology may experience transient or no pain relief, undergoing these injections (typically administered in a series of three) unnecessarily exposes them to the inherent risks, while also delaying surgery and potentially exposing them to more severe/permanent neurological deficits. Results: Multiple recent reports cite contaminated epidural steroid injections resulting in meningitis, stroke, paralysis, and death. The Center for Disease Control (CDC) specifically identified 25 deaths (many due to Aspergillosis), 337 patients sickened, and 14,000 exposed to contaminated steroids. Nevertheless, many other patients develop other complications that go unreported/underreported: Other life-threatening infections, spinal fluid leaks (0.4-6%), positional headaches (28%), adhesive arachnoiditis (6-16%), hydrocephalus, air embolism, urinary retention, allergic reactions, intravascular injections (7.9-11.6%), stroke, blindness, neurological deficits/paralysis, hematomas, seizures, and death. Conclusions: Although the benefits for epidural steroid injections may include transient pain relief for those with/without surgical disease, the multitude of risks attributed to these injections outweighs the benefits. PMID:23646278

Information theoretic partitioning and confidence based weight assignment for multi-classifier decision level fusion in hyperspectral target recognition applications

NASA Astrophysics Data System (ADS)