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Sample records for interbody fusion alif

  1. Comparison of ALIF vs. XLIF for L4/5 interbody fusion: pros, cons, and literature review

    PubMed Central

    Gambhir, Shanu

    2016-01-01

    The incidence of lumbar fusion for the treatment of various degenerative lumbar spine diseases has increased dramatically over the last twenty years. Many lumbar fusion techniques have been developed and popularized, each with its own advantages and disadvantages. Anterior lumbar interbody fusion (ALIF) initially introduced in the 1930’s, has become a common and widely accepted technique for lumbar fusions over the last decade offering several advantages over standard posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). More recently, the lateral trans-psoas approach termed extreme, direct or lateral lumbar interbody fusion (XLIF, DLIF, LLIF) is gaining widespread popularity. The aim of this paper is to compare the approaches, advantages and disadvantages of ALIF and XLIF for L4/5 interbody fusion based on relevant literature.

  2. Comparison of ALIF vs. XLIF for L4/5 interbody fusion: pros, cons, and literature review.

    PubMed

    Winder, Mark J; Gambhir, Shanu

    2016-03-01

    The incidence of lumbar fusion for the treatment of various degenerative lumbar spine diseases has increased dramatically over the last twenty years. Many lumbar fusion techniques have been developed and popularized, each with its own advantages and disadvantages. Anterior lumbar interbody fusion (ALIF) initially introduced in the 1930's, has become a common and widely accepted technique for lumbar fusions over the last decade offering several advantages over standard posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). More recently, the lateral trans-psoas approach termed extreme, direct or lateral lumbar interbody fusion (XLIF, DLIF, LLIF) is gaining widespread popularity. The aim of this paper is to compare the approaches, advantages and disadvantages of ALIF and XLIF for L4/5 interbody fusion based on relevant literature.

  3. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF

    PubMed Central

    Phan, Kevin; Malham, Greg; Seex, Kevin; Rao, Prashanth J.

    2015-01-01

    Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF). The indications may include: discogenic/facetogenic low back pain, neurogenic claudication, radiculopathy due to foraminal stenosis, lumbar degenerative spinal deformity including symptomatic spondylolisthesis and degenerative scoliosis. In general, traditional posterior approaches are frequently used with acceptable fusion rates and low complication rates, however they are limited by thecal sac and nerve root retraction, along with iatrogenic injury to the paraspinal musculature and disruption of the posterior tension band. Minimally invasive (MIS) posterior approaches have evolved in an attempt to reduce approach related complications. Anterior approaches avoid the spinal canal, cauda equina and nerve roots, however have issues with approach related abdominal and vascular complications. In addition, lateral and OLIF techniques have potential risks to the lumbar plexus and psoas muscle. The present study aims firstly to comprehensively review the available literature and evidence for different lumbar interbody fusion (LIF) techniques. Secondly, we propose a set of recommendations and guidelines

  4. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF.

    PubMed

    Mobbs, Ralph J; Phan, Kevin; Malham, Greg; Seex, Kevin; Rao, Prashanth J

    2015-12-01

    Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF). The indications may include: discogenic/facetogenic low back pain, neurogenic claudication, radiculopathy due to foraminal stenosis, lumbar degenerative spinal deformity including symptomatic spondylolisthesis and degenerative scoliosis. In general, traditional posterior approaches are frequently used with acceptable fusion rates and low complication rates, however they are limited by thecal sac and nerve root retraction, along with iatrogenic injury to the paraspinal musculature and disruption of the posterior tension band. Minimally invasive (MIS) posterior approaches have evolved in an attempt to reduce approach related complications. Anterior approaches avoid the spinal canal, cauda equina and nerve roots, however have issues with approach related abdominal and vascular complications. In addition, lateral and OLIF techniques have potential risks to the lumbar plexus and psoas muscle. The present study aims firstly to comprehensively review the available literature and evidence for different lumbar interbody fusion (LIF) techniques. Secondly, we propose a set of recommendations and guidelines

  5. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF.

    PubMed

    Mobbs, Ralph J; Phan, Kevin; Malham, Greg; Seex, Kevin; Rao, Prashanth J

    2015-12-01

    Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF). The indications may include: discogenic/facetogenic low back pain, neurogenic claudication, radiculopathy due to foraminal stenosis, lumbar degenerative spinal deformity including symptomatic spondylolisthesis and degenerative scoliosis. In general, traditional posterior approaches are frequently used with acceptable fusion rates and low complication rates, however they are limited by thecal sac and nerve root retraction, along with iatrogenic injury to the paraspinal musculature and disruption of the posterior tension band. Minimally invasive (MIS) posterior approaches have evolved in an attempt to reduce approach related complications. Anterior approaches avoid the spinal canal, cauda equina and nerve roots, however have issues with approach related abdominal and vascular complications. In addition, lateral and OLIF techniques have potential risks to the lumbar plexus and psoas muscle. The present study aims firstly to comprehensively review the available literature and evidence for different lumbar interbody fusion (LIF) techniques. Secondly, we propose a set of recommendations and guidelines

  6. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF

    PubMed Central

    Phan, Kevin; Malham, Greg; Seex, Kevin; Rao, Prashanth J.

    2015-01-01

    Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF). The indications may include: discogenic/facetogenic low back pain, neurogenic claudication, radiculopathy due to foraminal stenosis, lumbar degenerative spinal deformity including symptomatic spondylolisthesis and degenerative scoliosis. In general, traditional posterior approaches are frequently used with acceptable fusion rates and low complication rates, however they are limited by thecal sac and nerve root retraction, along with iatrogenic injury to the paraspinal musculature and disruption of the posterior tension band. Minimally invasive (MIS) posterior approaches have evolved in an attempt to reduce approach related complications. Anterior approaches avoid the spinal canal, cauda equina and nerve roots, however have issues with approach related abdominal and vascular complications. In addition, lateral and OLIF techniques have potential risks to the lumbar plexus and psoas muscle. The present study aims firstly to comprehensively review the available literature and evidence for different lumbar interbody fusion (LIF) techniques. Secondly, we propose a set of recommendations and guidelines

  7. Thirty-day readmission rate and risk factors for patients undergoing single level elective anterior lumbar interbody fusion (ALIF).

    PubMed

    Garcia, Roxanna M; Choy, Winward; DiDomenico, Joseph D; Barrington, Nikki; Dahdaleh, Nader S; Rodriguez, Heron E; Lam, Sandi; Smith, Zachary A

    2016-10-01

    Anterior lumbar interbody fusion (ALIF) represents a common interbody fusion technique and is advantageous given reduced risk of damage to the paraspinal muscles, posterior ligaments, and neural elements. In this study, we identified the readmission rate, common causes, and risk factors associated with single level ALIF 30-day readmission. Patients who underwent elective single level ALIF surgery from 2011 to 2013 were identified in the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database. Segmental fusion, emergency, and trauma cases were excluded. A total of 2,042 patients were identified from the ACS-NSQIP database from 2011 to 2013. The proportion of patients readmitted was 5.19% (106/2,042) and approximately 59.81% (64/106) had a reportable cause. The top three causes were poor post-operative pain control (11%), deep (9%) and superficial (9%) surgical site infections. Risk factors associated with 30-day readmission included age (odds ratio (OR)=1.02, 95% confidence interval (CI): 1.00-1.03, p value=0.05), history of severe chronic obstructive pulmonary disease (COPD), (OR=2.11, 95% CI: 0.95-4.70, p value=0.08), post-operative pneumonia (OR=6.58, 95% CI: 2.36-18.30, p value<0.001), and presence of superficial surgical site infection (OR=11.68, 95% CI: 4.88-27.95, p value<0.001). Bleeding disorders, anemia, and perioperative blood loss was not associated with 30-day readmission. Limitations include retrospective level 3 data, and missing data. This study represents the first nation-wide descriptive evaluation of 30-day readmission causes and risk factors for patients undergoing an ALIF procedure.

  8. Lateral Lumbar Interbody Fusion.

    PubMed

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

    2015-12-01

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

  9. Lateral Lumbar Interbody Fusion

    PubMed Central

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

    2015-01-01

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

  10. Evolution of Design of Interbody Cages for Anterior Lumbar Interbody Fusion.

    PubMed

    Phan, Kevin; Mobbs, Ralph J

    2016-08-01

    Anterior lumbar interbody fusion (ALIF) is one of the surgical procedures for the relief of chronic back pain, radiculopathy and neurogenic claudication in patients with degenerative lumbar spine disease that is refractory to conservative therapy, low-grade spondylolisthesis and pseudo arthrosis. Over the past half century, both the surgical techniques and instrumentation required for ALIF have changed significantly. In particular, the designs of ALIF cage and the materials used have evolved dramatically, the common goal being to improve fusion rates and optimize clinical outcomes. The increasing popularity of ALIF is reflected by the increasing abundance of published studies reporting clinical outcomes, surgical techniques and grafting options for ALIF. Developments in cage designs include cylindrical Bagby and Kuslich, cylindrical ray, cylindrical mesh, lumbar-tapered, polyethyl-etherketone cage and integral fixation cages. Biologic implants include bone dowels and femoral ring allografts. Methods for optimization of cage design have included cage dimensions, use of novel composite cage materials and integral fixation technologies. However, the historical development and evolution of cages used for ALIF has not been extensively documented. This article therefore aims to provide an overview of the historical basis for the anterior approach, evolution in design of ALIF cage implants and potential future research directions. PMID:27627708

  11. Current status of bone graft options for anterior interbody fusion of the cervical and lumbar spine.

    PubMed

    Chau, Anthony Minh Tien; Xu, Lileane Liang; Wong, Johnny Ho-Yin; Mobbs, Ralph Jasper

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) and anterior lumbar interbody fusion (ALIF) are common surgical procedures for degenerative disc disease of the cervical and lumbar spine. Over the years, many bone graft options have been developed and investigated aimed at complimenting or substituting autograft bone, the traditional fusion substrate. Here, we summarise the historical context, biological basis and current best evidence for these bone graft options in ACDF and ALIF. PMID:23743981

  12. Complication avoidance and management in anterior lumbar interbody fusion.

    PubMed

    Than, Khoi D; Wang, Anthony C; Rahman, Shayan U; Wilson, Thomas J; Valdivia, Juan M; Park, Paul; La Marca, Frank

    2011-10-01

    The goal of this study was to review the literature to compare strategies for avoiding and treating complications from anterior lumbar interbody fusion (ALIF), and thus provide a comprehensive aid for spine surgeons. A thorough review of databases from the US National Library of Medicine and the National Institutes of Health was conducted. The complications of ALIF addressed in this paper include pseudarthrosis and subsidence, vascular injury, retrograde ejaculation, ileus, and lymphocele (chyloretroperitoneum). Strategies identified for improving fusion rates included the use of frozen rather than freeze-dried allograft, cage instrumentation, and bone morphogenetic protein. Lower cage heights appear to reduce the risk of subsidence. The most common vascular injury is venous laceration, which occurs less frequently when using nonthreaded interbody grafts such as iliac crest autograft or femoral ring allograft. Left iliac artery thrombosis is the most common arterial injury, and its occurrence can be minimized by intermittent release of retraction intraoperatively. The risk of retrograde ejaculation is significantly higher with laparoscopic approaches, and thus should be avoided in male patients. Despite precautionary measures, complications from ALIF may occur, but treatment options do exist. Bowel obstruction can be treated conservatively with neostigmine or with decompression. In cases of postoperative lymphocele, resolution can be attained by creating a peritoneal window. By recognizing ways to minimize complications, the spine surgeon can safely use ALIF procedures.

  13. PEEK-Halo effect in interbody fusion.

    PubMed

    Phan, Kevin; Hogan, Jarred A; Assem, Yusuf; Mobbs, Ralph J

    2016-02-01

    Recent developments have seen poly[aryl-ether-ether-ketone] (PEEK) being increasingly used in vertebral body fusion. More novel approaches to improve PEEK have included the introduction of titanium-PEEK (Ti-PEEK) composites and coatings. This paper aims to describe a potential complication of PEEK based implants relating to poorer integration with the surrounding bone, producing a "PEEK-Halo" effect which is not seen in Ti-PEEK composite implants. We present images from two patients undergoing anterior lumbar interbody fusion (ALIF). The first patient underwent an L5/S1 ALIF using a PEEK implant whilst the second patient underwent L4/L5 ALIF using a Ti-PEEK composite implant. Evidence of osseointegration was sought using CT imaging and confirmed using histological preparations of a sheep tibia model. The PEEK-Halo effect is demonstrated by a halo effect between the PEEK implant and the bone graft on CT imaging. This phenomenon is secondary to poor osseointegration of PEEK implants. The PEEK-Halo effect was not demonstrated in the second patient who received a Ti-PEEK composite graft. Histological analysis of graft/bone interface surfaces in PEEK versus Ti-PEEK implants in a sheep model further confirmed poorer osseointegration of the PEEK implant. In conclusion, the PEEK-Halo effect is seen secondary to minimal osseointegration of PEEK at the adjacent vertebral endplate following a PEEK implant insertion. This effect is not seen with Ti-PEEK implants, and may support the role of titanium in improving the bone-implant interface of PEEK substrates. PMID:26474500

  14. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 11: interbody techniques for lumbar fusion.

    PubMed

    Mummaneni, Praveen V; Dhall, Sanjay S; Eck, Jason C; Groff, Michael W; Ghogawala, Zoher; Watters, William C; Dailey, Andrew T; Resnick, Daniel K; Choudhri, Tanvir F; Sharan, Alok; Wang, Jeffrey C; Kaiser, Michael G

    2014-07-01

    Interbody fusion techniques have been promoted as an adjunct to lumbar fusion procedures in an effort to enhance fusion rates and potentially improve clinical outcome. The medical evidence continues to suggest that interbody techniques are associated with higher fusion rates compared with posterolateral lumbar fusion (PLF) in patients with degenerative spondylolisthesis who demonstrate preoperative instability. There is no conclusive evidence demonstrating improved clinical or radiographic outcomes based on the different interbody fusion techniques. The addition of a PLF when posterior or anterior interbody lumbar fusion is performed remains an option, although due to increased cost and complications, it is not recommended. No substantial clinical benefit has been demonstrated when a PLF is included with an interbody fusion. For lumbar degenerative disc disease without instability, there is moderate evidence that the standalone anterior lumbar interbody fusion (ALIF) has better clinical outcomes than the ALIF plus instrumented, open PLF. With regard to type of interbody spacer used, frozen allograft is associated with lower pseudarthrosis rates compared with freeze-dried allograft; however, this was not associated with a difference in clinical outcome.

  15. L5-S1 Laparoscopic Anterior Interbody Fusion

    PubMed Central

    Zeni, Tallal M.; Phillips, Frank M.; Mathur, Sameer; Zografakis, John G.; Moore, Ronald M.; Laguna, Luis E.

    2006-01-01

    Objective: We evaluated our experience with laparoscopic L5-S1 anterior lumbar interbody fusion (ALIF). Methods: This represents a retrospective analysis of consecutive patients who underwent L5-S1 laparoscopic ALIF between February 1998 and August 2003. Results: Twenty-eight patients underwent L5-S1 LAIF (15 males and 13 females). The mean age was 43 years (range, 26 to 67). Mean operative time was 225 minutes (range, 137 to 309 minutes). No conversions to an open procedure were necessary. Twenty-four (85.7%) patients underwent successful bilateral cage placement. Four patients (14.3%) in whom only a single cage could be placed underwent supplementary posterior pedicle screw placement. Mean length of stay (LOS) was 4.1 days (range, 2 to 15). Two patients underwent reoperation subacutely secondary to symptomatic lateral displacement of the cage. One patient developed radiculopathy 6 months postoperatively and required reoperation. One patient developed a small bowel obstruction secondary to adhesions to the cage requiring laparoscopic reoperation. Fusion was achieved in all patients. Visual analogue scale scores for back pain were significantly improved from 8.6±0.8 to 2.8±0.8 (P<0.0001) at 1 year. Conclusion: L5-S1 LAIF is feasible and safe with all the advantages of minimally invasive surgery. Fusion rates and pain improvement were comparable to those with an open repair. PMID:17575763

  16. Choice of Approach Does Not Affect Clinical and Radiologic Outcomes: A Comparative Cohort of Patients Having Anterior Lumbar Interbody Fusion and Patients Having Lateral Lumbar Interbody Fusion at 24 Months

    PubMed Central

    Malham, Gregory M.; Parker, Rhiannon M.; Blecher, Carl M.; Chow, Fiona Y.; Seex, Kevin A.

    2015-01-01

    Study Design  Retrospective analysis of prospectively collected registry data. Objective  This study aimed to compare the clinical and radiologic outcomes between comparative cohorts of patients having anterior lumbar interbody fusion (ALIF) and patients having lateral lumbar interbody fusion (LLIF). Methods  Ninety consecutive patients were treated by a single surgeon with either ALIF (n = 50) or LLIF (n = 40). Inclusion criteria were patients age 45 to 70 years with degenerative disk disease or grade 1 to 2 spondylolisthesis and single-level pathology from L1 to S1. Patient-reported outcome measures included pain (visual analog scale), disability (Oswestry Disability Index [ODI]), and quality of life (Short Form 36 physical component score [PCS] and mental component scores [MCS]). Assessment of fusion and measurement of lordosis and posterior disk height were performed on computed tomography scans. Results  At 24 months, patients having ALIF had significant improvements in back (64%) and leg (65%) pain and ODI (60%), PCS (44%), and MCS (26%; p < 0.05) scores. Patients having LLIF had significant improvements in back (56%) and leg (57%) pain and ODI (52%), PCS (48%), and MCS (12%; p < 0.05) scores. Fourteen complications occurred in the ALIF group, and in the LLIF group, there were 17 complications (p > 0.05). The fusion rate was 100% for ALIF and 95% for LLIF (p = 0.1948). ALIF added ∼6 degrees of lordosis and 3 mm of height, primarily measured at L5–S1, and LLIF added ∼3 degrees of lordosis and 2 mm of height between L1 to L5. Mean follow-up was 34.1 months. Conclusions  In comparative cohorts of patients having ALIF and patients having LLIF at 24 months postoperatively, there were no significant differences in clinical outcomes, complication rates, or fusion rates. PMID:27433432

  17. Minimally invasive transforaminal lumbosacral interbody fusion.

    PubMed

    Chang, Peng-Yuan; Wang, Michael Y

    2016-07-01

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

  18. 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

  19. The VariLift® Interbody Fusion System: expandable, standalone interbody fusion

    PubMed Central

    Emstad, Erik; del Monaco, Diana Cardenas; Fielding, Louis C; Block, Jon E

    2015-01-01

    Intervertebral fusion cages have been in clinical use since the 1990s. Cages offer the benefits of bone graft containment, restored intervertebral and foraminal height, and a more repeatable, stable procedure compared to interbody fusion with graft material alone. Due to concerns regarding postoperative stability, loss of lordosis, and subsidence or migration of the implant, interbody cages are commonly used with supplemental fixation such as pedicle screw systems or anterior plates. While providing additional stability, supplemental fixation techniques increase operative time, exposure, cost, and morbidity. The VariLift® Interbody Fusion System (VariLift® system) has been developed as a standalone solution to provide the benefits of intervertebral fusion cages without the requirement of supplemental fixation. The VariLift® system, FDA-cleared for standalone use in both the cervical and lumbar spine, is implanted in a minimal profile and then expanded in situ to provide segmental stability, restored lordosis, and a large graft chamber. Preclinical testing and analyses have found that the VariLift® System is durable, and reduces stresses that may contribute to subsidence and migration of other standalone interbody cages. Fifteen years of clinical development with the VariLift® system have demonstrated positive clinical outcomes, continued patient maintenance of segmental stability and lordosis, and no evidence of implant migration. The purpose of this report is to describe the VariLift® system, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The VariLift® System represents an improved surgical option for a stable interbody fusion without requiring supplemental fixation. PMID:26060414

  20. Instrumented posterior lumbar interbody fusion (PLIF) with interbody fusion device (Cage) in degenerative disc disease (DDD): 3 years outcome.

    PubMed

    Ahsan, M K; Hossain, M A; Sakeb, N; Khan, S I; Zaman, N

    2013-10-01

    This prospective interventional study carried out at Bangabandhu Sheikh Mujib Medical University and a private hospital in Dhaka, Bangladesh during the period from October 2003 to September 2011. Surgical treatment of degenerative disc disease (DDD) should aim to re-expand the interbody space and stabilize until fusion is complete. The present study conducted to find out the efficacy of using interbody fusion device (Cage) to achieve interbody space re-expansion and fusion in surgical management of DDD. We have performed the interventional study on 53 patients, 42 female and 11 male, with age between 40 to 67 years. All the patients were followed up for 36 to 60 months (average 48 months). Forty seven patients were with spondylolisthesis and 06 with desiccated disc. All subjects were evaluated with regard to immediate and long term complications, radiological fusion and interbody space re-expansion and maintenance. The clinical outcome (pain and disability) was scored by standard pre and postoperative questionnaires. Intrusion, extrusion and migration of the interbody fusion cage were also assessed. Forty seven patients were considered to have satisfactory outcome in at least 36 months follow up. Pseudoarthrosis developed in 04 cases and 06 patients developed complications. In this series posterior lumbar interbody fusion (PLIF) with interbody cage and instrumentation in DDD showed significant fusion rate and maintenance of interbody space. Satisfactory outcome observed in 88.68% cases.

  1. Minimally Invasive Transforaminal Lumbar Interbody Fusion.

    PubMed

    Ahn, Junyoung; Tabaraee, Ehsan; Singh, Kern

    2015-07-01

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

  2. Multiexpandable cage for minimally invasive posterior lumbar interbody fusion

    PubMed Central

    Coe, Jeffrey D; Zucherman, James F; Kucharzyk, Donald W; Poelstra, Kornelis A; Miller, Larry E; Kunwar, Sandeep

    2016-01-01

    The increasing adoption of minimally invasive techniques for spine surgery in recent years has led to significant advancements in instrumentation for lumbar interbody fusion. Percutaneous pedicle screw fixation is now a mature technology, but the role of expandable cages is still evolving. The capability to deliver a multiexpandable interbody cage with a large footprint through a narrow surgical cannula represents a significant advancement in spinal surgery technology. The purpose of this report is to describe a multiexpandable lumbar interbody fusion cage, including implant characteristics, intended use, surgical technique, preclinical testing, and early clinical experience. Results to date suggest that the multiexpandable cage allows a less invasive approach to posterior/transforaminal lumbar interbody fusion surgery by minimizing iatrogenic risks associated with static or vertically expanding interbody prostheses while providing immediate vertebral height restoration, restoration of anatomic alignment, and excellent early-term clinical results. PMID:27729817

  3. Analysis of spinal lumbar interbody fusion cage subsidence using Taguchi method, finite element analysis, and artificial neural network

    NASA Astrophysics Data System (ADS)

    Nassau, Christopher John; Litofsky, N. Scott; Lin, Yuyi

    2012-09-01

    Subsidence, when implant penetration induces failure of the vertebral body, occurs commonly after spinal reconstruction. Anterior lumbar interbody fusion (ALIF) cages may subside into the vertebral body and lead to kyphotic deformity. No previous studies have utilized an artificial neural network (ANN) for the design of a spinal interbody fusion cage. In this study, the neural network was applied after initiation from a Taguchi L 18 orthogonal design array. Three-dimensional finite element analysis (FEA) was performed to address the resistance to subsidence based on the design changes of the material and cage contact region, including design of the ridges and size of the graft area. The calculated subsidence is derived from the ANN objective function which is defined as the resulting maximum von Mises stress (VMS) on the surface of a simulated bone body after axial compressive loading. The ANN was found to have minimized the bone surface VMS, thereby optimizing the ALIF cage given the design space. Therefore, the Taguchi-FEA-ANN approach can serve as an effective procedure for designing a spinal fusion cage and improving the biomechanical properties.

  4. Comparison of the different surgical approaches for lumbar interbody fusion.

    PubMed

    Talia, Adrian J; Wong, Michael L; Lau, Hui C; Kaye, Andrew H

    2015-02-01

    This review will outline the history of spinal fusion. It will compare the different approaches currently in use for interbody fusion. A comparison of the techniques, including minimally invasive surgery and graft options will be included. Lumbar interbody fusion is a commonly performed surgical procedure for a variety of spinal disorders, especially degenerative disease. Currently this procedure is performed using anterior, lateral, transforaminal and posterior approaches. Minimally invasive techniques have been increasing in popularity in recent years. A posterior approach is frequently used and has good fusion rates and low complication rates but is limited by the thecal and nerve root retraction. The transforaminal interbody fusion avoids some of these complications and is therefore preferable in some situations, especially revision surgery. An anterior approach avoids the spinal cord and cauda equina all together, but has issues with visceral exposure complications. Lateral lumbar interbody fusion has a risk of lumbar plexus injury with dissection through the psoas muscle. Studies show less intraoperative blood loss for minimally invasive techniques, but there is no long-term data. Iliac crest is the gold standard for bone graft, although adjuncts such as bone morphogenetic proteins are being used more frequently, despite their controversial history. More high-level studies are needed to make generalisations regarding the outcomes of one technique compared with another.

  5. Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease: A pilot study and a literature review.

    PubMed

    Udby, Peter M; Bech-Azeddine, Rachid

    2015-06-01

    The objective of the article was to: a) present results from a case cohort pilot study comparing stand-alone ALIF and TLIF and, b) review the literature on studies comparing the clinical outcome of stand-alone ALIF with posterior instrumentation including TLIF or PLIF, in patients with disabling low back pain resulting from degenerative disc disease. ALIF surgery has previously been linked with certain high risk complications and unfavorable long term fusion results. Newer studies suggest that stand-alone ALIF can possibly be advantageous compared to other types of posterior instrumented interbody fusion for a selected group of DDD patients. The methods and material consisted of a cohort pilot study of patients, with DDD treated with stand-alone ALIF or TLIF followed by a literature review conducted through a comprehensive PubMed database search of the English literature. Studies comparing stand-alone ALIF with posterior instrumented interbody fusion were selected and reviewed. Results from the pilot study, n = 21, showed a reduced perioperative blood loss, shorter operative time and a trend towards better pain reduction and decreased use of opioid analgesics in patients undergoing stand-alone ALIF compared to posterior instrumented fusion with TLIF. The literature review included three studies, n = 630. All three studies were retrospective cohort studies. The average patient follow-up was 2-years but with heterogeneous selected outcomes. Two of three articles documented significant advantages when using stand-alone ALIF on outcomes such as ODI, VAS, surgical time, blood loss and patient satisfaction. No study found stand-alone ALIF inferior in chosen outcomes including fusion. In conclusion the pilot study and the literature review, finds similar clinical outcomes and fusion rates after stand-alone ALIF and posterior interbody fusion. Stand-alone ALIF was associated with a shorter duration of surgery, less perioperative blood loss and a faster improvement post

  6. Biomechanical comparison of two different concepts for stand alone anterior lumbar interbody fusion.

    PubMed

    Schleicher, Philipp; Gerlach, R; Schär, B; Cain, C M J; Achatz, W; Pflugmacher, R; Haas, N P; Kandziora, F

    2008-12-01

    Segmental instability in degenerative disc disease is often treated with anterior lumbar interbody fusion (ALIF). Current techniques require an additional posterior approach to achieve sufficient stability. The test device is an implant which consists of a PEEK-body and an integrated anterior titanium plate hosting four diverging locking screws. The test device avoids posterior fixation by enhancing stability via the locking screws. The test device was compared to an already established stand alone interbody implant in a human cadaveric three-dimensional stiffness test. In the biomechanical test, the L4/5 motion segment of 16 human cadaveric lumbar spines were isolated and divided into two test groups. Tests were performed in flexion, extension, right and left lateral bending, right and left axial rotation. Each specimen was tested in native state first, then a discectomy was performed and either of the test implants was applied. Finite element analysis (FE) was also performed to investigate load and stress distribution within the implant in several loading conditions. The FE models simulated two load cases. These were flexion and extension with a moment of 5 Nm. The biomechanical testing revealed a greater stiffness in lateral bending for the SynFix-LR compared to the established implant. Both implants showed a significantly higher stiffness in all loading directions compared to the native segment. In flexion loading, the PEEK component takes on most of the load, whereas the majority of the extension load is put on the screws and the screw-plate junction. Clinical investigation of the test device seems reasonable based on the good results reported here.

  7. Minimal invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion

    PubMed Central

    Kulkarni, Arvind G; Bohra, Hussain; Dhruv, Abhilash; Sarraf, Abhishek; Bassi, Anupreet; Patil, Vishwanath M

    2016-01-01

    Background: The aim of the present prospective study is to evaluate whether the touted advantages of minimal invasive-transforaminal lumbar interbody fusion (MI-TLIF) translate into superior, equal, or inferior outcomes as compared to open-transforaminal lumbar interbody fusion (O-TLIF). This is the first study from the Indian subcontinent prospectively comparing the outcomes of MI-TLIF and O-TLIF. Materials and Methods: All consecutive cases of open and MI-TLIF were prospectively followed up. Single-level TLIF procedures for spondylolytic and degenerative conditions (degenerative spondylolisthesis, central disc herniations) operated between January 2011 and January 2013 were included. The pre and postoperative Oswestry Disability Index (ODI) and visual analog scale (VAS) for back pain and leg pain, length of hospital stay, operative time, radiation exposure, quantitative C-reactive protein (QCRP), and blood loss were compared between the two groups. The parameters were statistically analyzed (using IBM® SPSS® Statistics version 17). Results: 129 patients underwent TLIF procedure during the study period of which, 71 patients (46 MI-TLIF and 25 O-TLIF) fulfilled the inclusion criteria. Of these, a further 10 patients were excluded on account of insufficient data and/or no followup. The mean followup was 36.5 months (range 18-54 months). The duration of hospital stay (O-TLIF 5.84 days + 2.249, MI-TLIF 4.11 days + 1.8, P < 0.05) was shorter in MI-TLIF cases. There was less blood loss (open 358.8 ml, MI 111.81 ml, P < 0.05) in MI-TLIF cases. The operative time (O-TLIF 2.96 h + 0.57, MI-TLIF 3.40 h + 0.54, P < 0.05) was longer in MI group. On an average, 57.77 fluoroscopic exposures were required in MI-TLIF which was significantly higher than in O-TLIF (8.2). There was no statistically significant difference in the improvement in ODI and VAS scores in MI-TLIF and O-TLIF groups. The change in QCRP values preoperative and postoperative was significantly lower (P < 0

  8. Current Status of Lumbar Interbody Fusion for Degenerative Spondylolisthesis

    PubMed Central

    TAKAHASHI, Toshiyuki; HANAKITA, Junya; OHTAKE, Yasufumi; FUNAKOSHI, Yusuke; OICHI, Yuki; KAWAOKA, Taigo; WATANABE, Mizuki

    2016-01-01

    Instrumented lumbar fusion can provide immediate stability and assist in satisfactory arthrodesis in patients who have pain or instability of the lumbar spine. Lumbar adjunctive fusion with decompression is often a good procedure for surgical management of degenerative spondylolisthesis (DS). Among various lumbar fusion techniques, lumbar interbody fusion (LIF) has an advantage in that it maintains favorable lumbar alignment and provides successful fusion with the added effect of indirect decompression. This technique has been widely used and represents an advancement in spinal instrumentation, although the rationale and optimal type of LIF for DS remains controversial. We evaluated the current status and role of LIF in DS treatment, mainly as a means to augment instrumentation. We addressed the basic concept of LIF, its indications, and various types including minimally invasive techniques. It also has acceptable biomechanical features, and offers reconstruction with ideal lumbar alignment. Postsurgical adverse events related to each LIF technique are also addressed. PMID:27169496

  9. Theoretical model of a piezoelectric composite spinal fusion interbody implant.

    PubMed

    Tobaben, Nicholas E; Domann, John P; Arnold, Paul M; Friis, Elizabeth A

    2014-04-01

    Failure rates of spinal fusion are high in smokers and diabetics. The authors are investigating the development of a piezoelectric composite biomaterial and interbody device design that could generate clinically relevant levels of electrical stimulation to help improve the rate of fusion for these patients. A lumped parameter model of the piezoelectric composite implant was developed based on a model that has been utilized to successfully predict power generation for piezoceramics. Seven variables (fiber material, matrix material, fiber volume fraction, fiber aspect ratio, implant cross-sectional area, implant thickness, and electrical load resistance) were parametrically analyzed to determine their effects on power generation within reasonable implant constraints. Influences of implant geometry and fiber aspect ratio were independent of material parameters. For a cyclic force of constant magnitude, implant thickness was directly and cross-sectional area inversely proportional to power generation potential. Fiber aspect ratios above 30 yielded maximum power generation potential while volume fractions above 15% showed superior performance. This investigation demonstrates the feasibility of using composite piezoelectric biomaterials in medical implants to generate therapeutic levels of direct current electrical stimulation. The piezoelectric spinal fusion interbody implant shows promise for helping increase success rates of spinal fusion.

  10. Sagittal Balance Correction in Lateral Interbody Fusion for Degenerative Scoliosis

    PubMed Central

    Gallizzi, Michael A.; Sheets, Charles; Smith, Benjamin T.; Isaacs, Robert E.; Eure, Megan; Brown, Christopher R.

    2016-01-01

    Background Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population. The objective of this study is to evaluate the ability of LIF to restore sagittal balance in degenerative lumbar scoliosis. Methods Thirty-five patients who underwent LIF for degenerative thoracolumbar scoliosis from July 2013 to March 2014 by a single surgeon were included. Outcome measures included sagittal balance, lumbar lordosis, Cobb Angle, and segmental lordosis. Measures were evaluated pre-operative, immediately post-operatively, and at their last clinical follow-up. Repeated measures ANOVAs were used to assess the differences between pre-operative, first postoperative, and a follow-up visit. Results The average sagittal balance correction was not significantly different: 1.06cm from 5.79cm to 4.74cm forward. The average Cobb angle correction was 14.1 degrees from 21.6 to 5.5 degrees. The average change in global lumbar lordosis was found to be significantly different: 6.3 degrees from 28.9 to 35.2 degrees. Conclusions This study demonstrates that LIF reliably restores lordosis, but does not significantly improve sagittal balance. Despite this, patients had reliable improvement in pain and functionality suggesting that sagittal balance correction may not be as critical in scoliosis correction as previous studies have indicated. Clinical Relevance LIF does not significantly change sagittal balance; however, clinical improvement does not seem to be contingent upon sagittal balance correction in the degenerative scoliosis population. The DUHS IRB has determined this

  11. Sagittal Balance Correction in Lateral Interbody Fusion for Degenerative Scoliosis

    PubMed Central

    Gallizzi, Michael A.; Sheets, Charles; Smith, Benjamin T.; Isaacs, Robert E.; Eure, Megan; Brown, Christopher R.

    2016-01-01

    Background Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population. The objective of this study is to evaluate the ability of LIF to restore sagittal balance in degenerative lumbar scoliosis. Methods Thirty-five patients who underwent LIF for degenerative thoracolumbar scoliosis from July 2013 to March 2014 by a single surgeon were included. Outcome measures included sagittal balance, lumbar lordosis, Cobb Angle, and segmental lordosis. Measures were evaluated pre-operative, immediately post-operatively, and at their last clinical follow-up. Repeated measures ANOVAs were used to assess the differences between pre-operative, first postoperative, and a follow-up visit. Results The average sagittal balance correction was not significantly different: 1.06cm from 5.79cm to 4.74cm forward. The average Cobb angle correction was 14.1 degrees from 21.6 to 5.5 degrees. The average change in global lumbar lordosis was found to be significantly different: 6.3 degrees from 28.9 to 35.2 degrees. Conclusions This study demonstrates that LIF reliably restores lordosis, but does not significantly improve sagittal balance. Despite this, patients had reliable improvement in pain and functionality suggesting that sagittal balance correction may not be as critical in scoliosis correction as previous studies have indicated. Clinical Relevance LIF does not significantly change sagittal balance; however, clinical improvement does not seem to be contingent upon sagittal balance correction in the degenerative scoliosis population. The DUHS IRB has determined this

  12. Outcome of instrumented lumbar fusion for low grade spondylolisthesis; Evaluation of interbody fusion with & without cages

    PubMed Central

    Fathy, Mostafa; Fahmy, Mohamed; Fakhri, Mazen; Aref, Khaled; Abdin, Khaled; Zidan, Ihab

    2010-01-01

    Object: The aim is to evalute the outcome of posterior lumbar interbody fusion with autologous bone graft versus titanium Cages, BAK system (Bagby – Kuslich, Spine Tech, Inc. Minneapolis, MN) for low grade spondyloisthesis (Grade1,11). Interbody cages have been developed to replace tricortical Interbody grafts in posterior lumbar interbody fusion (PLIF) procedures. The cages provide immediate post operative stability and facilitate bony union with cancellous bone packed in the cage itself. METHOD: We Evaluated 50 consecutive patients in whom surgery was performed between June 2000 to June 2003 in the Main Alexandria University Hospital at EGYPT. Twenty five patients were operated using autologous bone graft and 25 patients using the BAK cages. The neuro–radiologic al work up consisted of; plain X – ray lumbosacral spine including dynamic films preoperative and postoperative follow up; C.T lumbosacral spine and MRI lumbosacral spine. The surgery was performed at L4-5 level in 34 cases and at L5-S1 level in 16 cases. The median follow up was 15 months. RESULTS: Satisfactory fusion was obtained at all levels at a minimum one year follow – up. The fusion rate was 96% (24 patients) for the cage group and 80% (20 patients) for bone graft group however clinical improvement was 64% (16 patients) for those with bone graft group. CONCLUSION: A higher fusion rates and a better clinical outcome have been obtained by Instrumented PLIF with titanium cages that with bone graft. Inderbody fusion cages help to stabilize spainal segment primarily by distracting them as well as by allowing bone ingrowth and fusion. The procedure is safe and effective with 96% fusion rate and 76% overall Satisfactory rate. The use of cages help to distract the space between the vertebral bodies making the correction of the degree of spondylolisthesis easier. Long term follow up revealed better fusion rate and better realignment and less resorption with cages than with bone grafts. PMID

  13. Ceramic interspinous block (CISB) assisted anterior interbody fusion.

    PubMed

    Tsuji, H; Hirano, N; Katoh, Y; Ohsima, H; Ishihara, H; Matsui, H; Hayashi, Y

    1990-03-01

    Ceramic interspinous block (CISB) assisted anterior fusion system was developed. The system is recommended for patients with symptomatic disc degeneration and destructive lesions of the lumbar spine. One hundred and six patients who underwent CISB-assisted anterior fusion by one doctor (H.T.) from 1981 to 1987 were followed-up 2-6 years after the operation. A comparative study of the results between the CISB-assisted group and the CISB-unassisted anterior fusion group, performed by the same doctor during 1979-1981 for deranged disc, was also done. Satisfactory relief of back and leg pains, marked ADL recovery and early bone union were obtained in all of the CISB-assisted anterior fusion cases. The union rate was 98.9% in the CISB-assisted anterior fusion group, whereas in the CISB-unassisted group, it averaged 79%. The efficacy of CISB for anterior interbody fusion was also verified using a computer simulation. CISB implementation appears to create equalization of stress distribution on the graft-vertebra interface.

  14. Direct lateral interbody fusion (DLIF) at the lumbosacral junction L5-S1.

    PubMed

    Shirzadi, Ali; Birch, Kurtis; Drazin, Doniel; Liu, John C; Acosta, Frank

    2012-07-01

    The direct lateral interbody fusion (DLIF), a minimally invasive lateral approach for placement of an interbody fusion device, does not require nerve root retraction or any contact with the great vessels and can lead to short operative times with little blood loss. Due to anatomical restrictions, this procedure has not been used at the lumbosacral (L5-S1) junction. Lumbosacral transitional vertebrae (LSTV), a structural anomaly of the lumbosacral spine associated with low back pain, can result in a level being wrongly identified pre-operatively due to misnumbering of the vertebral levels. To our knowledge, use of the DLIF graft in this patient is the first report of an interbody fusion graft being placed at the disc space between the LSTV and S1 via the transpsoas route. We present a review of the literature regarding the LSTV variation as well as the lateral placement of interbody fusion grafts at the lumbosacral junction.

  15. Modified Mini-open Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Pakzaban, Peyman

    2016-01-01

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

  16. Analysis of Internet Information on Lateral Lumbar Interbody Fusion.

    PubMed

    Belayneh, Rebekah; Mesfin, Addisu

    2016-07-01

    Lateral lumbar interbody fusion (LLIF) is a surgical technique that is being increasingly used. The authors' objective was to examine information on the Internet pertaining to the LLIF technique. An analysis was conducted of publicly accessible websites pertaining to LLIF. The following search engines were used: Google (www.google.com), Bing (www.bing.com), and Yahoo (www.yahoo.com). DuckDuckGo (www.duckduckgo.com) was an additional search engine used due to its emphasis on generating accurate and consistent results while protecting searchers' privacy and reducing advertisements. The top 35 websites providing information on LLIF from the 4 search engines were identified. A total of 140 websites were evaluated. Each web-site was categorized based on authorship (academic, private, medical industry, insurance company, other) and content of information. Using the search term lateral lumbar interbody fusion, 174,000 Google results, 112,000 Yahoo results, and 112,000 Bing results were obtained. DuckDuckGo does not display the number of results found for a search. From the top 140 websites collected from each website, 78 unique websites were identified. Websites were authored by a private medical group in 46.2% of the cases, an academic medical group in 26.9% of the cases, and the biomedical industry in 5.1% of the cases. Sixty-eight percent of websites reported indications, and 24.4% reported contraindications. Benefits of LLIF were reported by 69.2% of websites. Thirty-six percent of websites reported complications of LLIF. Overall, the quality of information regarding LLIF on the Internet is poor. Spine surgeons and spine societies can assist in improving the quality of the information on the Internet regarding LLIF. [Orthopedics. 2016; 39(4):e701-e707.]. PMID:27111081

  17. Analysis of Internet Information on Lateral Lumbar Interbody Fusion.

    PubMed

    Belayneh, Rebekah; Mesfin, Addisu

    2016-07-01

    Lateral lumbar interbody fusion (LLIF) is a surgical technique that is being increasingly used. The authors' objective was to examine information on the Internet pertaining to the LLIF technique. An analysis was conducted of publicly accessible websites pertaining to LLIF. The following search engines were used: Google (www.google.com), Bing (www.bing.com), and Yahoo (www.yahoo.com). DuckDuckGo (www.duckduckgo.com) was an additional search engine used due to its emphasis on generating accurate and consistent results while protecting searchers' privacy and reducing advertisements. The top 35 websites providing information on LLIF from the 4 search engines were identified. A total of 140 websites were evaluated. Each web-site was categorized based on authorship (academic, private, medical industry, insurance company, other) and content of information. Using the search term lateral lumbar interbody fusion, 174,000 Google results, 112,000 Yahoo results, and 112,000 Bing results were obtained. DuckDuckGo does not display the number of results found for a search. From the top 140 websites collected from each website, 78 unique websites were identified. Websites were authored by a private medical group in 46.2% of the cases, an academic medical group in 26.9% of the cases, and the biomedical industry in 5.1% of the cases. Sixty-eight percent of websites reported indications, and 24.4% reported contraindications. Benefits of LLIF were reported by 69.2% of websites. Thirty-six percent of websites reported complications of LLIF. Overall, the quality of information regarding LLIF on the Internet is poor. Spine surgeons and spine societies can assist in improving the quality of the information on the Internet regarding LLIF. [Orthopedics. 2016; 39(4):e701-e707.].

  18. Clinical and Radiological Outcomes of Segmental Spinal Fusion in Transforaminal Lumbar Interbody Fusion with Spinous Process Tricortical Autograft

    PubMed Central

    Tangviriyapaiboon, Teera

    2014-01-01

    Study Design A retrospective study. Purpose To investigate clinical and radiological outcomes when using spinous process as a tricortical autograft for segmental spinal fusion in transforaminal lumbar interbody fusion (TLIF). Overview of Literature Interbody spinal fusion is one of the important procedures in spinal surgery. Many types of autografts are harvested at the expense of complications. Clinical and radiographic results of patients who underwent TLIF with intraoperative harvested spinous process autograft in Prasat Neurological Institue, Bangkok, Thailand, were assessed as new technical innovation. Methods Between October 2005 to July 2009, 30 cases of patients who underwent TLIF with spinous process tricortical autograft were included. Clinical evaluations were assessed by visual analog scales (VAS) and Prolo functional and economic scores at the preoperation and postoperation and at 2 years postoperation. Static and dynamic plain radiograph of lumbar spine were reviewed for achievement of fusion. Results Initial successful fusion time in lumbar interbody fusion with spinous process tricortical autograft was 4.72 months (range, 3.8-6.1 months) postoperation and 100% fusion rate was reported at 2 years. Our initial successful fusion time in lumbar interbody fusion was compared to the other types of grafts in previous literatures. Conclusions The use of intraoperative harvested spinous process tricortical autograft has overcome many disadvantages of harvesting autograft with better initial successful fusion time (4.72 months). VAS and Prolo scores showed some improvement in the outcomes between the preoperative and postoperative periods. PMID:24761199

  19. Treatment of symptomatic thoracic disc herniations with lateral interbody fusion

    PubMed Central

    Parker, Rhiannon M.

    2015-01-01

    Background Symptomatic thoracic herniated discs have historically been treated using open exposures (i.e., thoracotomy), posing a clinical challenge given the approach related morbidity. Lateral interbody fusion (LIF) is one modern minimally disruptive alternative to thoracotomy. The direct lateral technique for lumbar pathologies has seen a sharp increase in procedural numbers; however application of this technique in thoracic pathologies has not been widely reported. Methods This study presents the results of three cases where LIF was used to treat symptomatic thoracic disc herniations. Indications for surgery included thoracic myelopathy, radiculopathy and discogenic pain. Patients were treated with LIF, without supplemental internal fixation, and followed for 24 months postoperatively. Results: Average length of hospital stay was 5 days. One patient experienced mild persistent neuropathic thoracic pain, which was managed medically. At 3 months postoperative all patients had returned to work and by 12 months all patients were fused. From preoperative to 24-month follow-up there were mean improvements of 83.3% in visual analogue scale (VAS), 75.3% in Oswestry Disability Index (ODI), and 79.2% and 17.4% in SF-36 physical (PCS) and mental component scores (MCS), respectively. Conclusions LIF is a viable minimally invasive alternative to conventional approaches in treating symptomatic thoracic pathology without an access surgeon, rib resection, or lung deflation.

  20. Repeated adjacent-segment degeneration after posterior lumbar interbody fusion.

    PubMed

    Okuda, Shinya; Oda, Takenori; Yamasaki, Ryoji; Maeno, Takafumi; Iwasaki, Motoki

    2014-05-01

    One of the most important sequelae affecting long-term results is adjacent-segment degeneration (ASD) after posterior lumbar interbody fusion (PLIF). Although several reports have described the incidence rate, there have been no reports of repeated ASD. The purpose of this report was to describe 1 case of repeated ASD after PLIF. A 62-year-old woman with L-4 degenerative spondylolisthesis underwent PLIF at L4-5. At the second operation, L3-4 PLIF was performed for L-3 degenerative spondylolisthesis 6 years after the primary operation. At the third operation, L2-3 PLIF was performed for L-2 degenerative spondylolisthesis 1.5 years after the primary operation. Vertebral collapse of L-1 was detected 1 year after the third operation, and the collapse had progressed. At the fourth operation, 3 years after the third operation, vertebral column resection of L-1 and replacement of titanium mesh cages with pedicle screw fixation between T-4 and L-5 was performed. Although the patient's symptoms resolved after each operation, the time between surgeries shortened. The sacral slope decreased gradually although each PLIF achieved local lordosis at the fused segment.

  1. Matched Comparison of Fusion Rates between Hydroxyapatite Demineralized Bone Matrix and Autograft in Lumbar Interbody Fusion

    PubMed Central

    Kim, Dae Hwan; Lee, Nam; Shin, Dong Ah; Yi, Seong; Kim, Keung Nyun

    2016-01-01

    Objective To compare the fusion rate of a hydroxyapatite demineralized bone matrix (DBM) with post-laminectomy acquired autograft in lumbar interbody fusion surgery and to evaluate the correlation between fusion rate and clinical outcome. Methods From January 2013 to April 2014, 98 patients underwent lumbar interbody fusion surgery with hydroxyapatite DBM (HA-DBM group) in our institute. Of those patients, 65 received complete CT scans for 12 months postoperatively in order to evaluate fusion status. For comparison with autograft, we selected another 65 patients who underwent lumbar interbody fusion surgery with post-laminectomy acquired autograft (Autograft group) during the same period. Both fusion material groups were matched in terms of age, sex, body mass index (BMI), and bone mineral density (BMD). To evaluate the clinical outcomes, we analyzed the results of visual analogue scale (VAS), Oswestry Disability Index (ODI), and Short Form Health Survey (SF-36). Results We reviewed the CT scans of 149 fusion levels in 130 patients (HA-DBM group, 75 levels/65 patients; Autograft group, 74 levels/65 patients). Age, sex, BMI, and BMD were not significantly different between the groups (p=0.528, p=0.848, p=0.527, and p=0.610, respectively). The HA-DBM group showed 39 of 75 fused levels (52%), and the Autograft group showed 46 of 74 fused levels (62.2%). This difference was not statistically significant (p=0.21). In the HA-DBM group, older age and low BMD were significantly associated with non-fusion (61.24 vs. 66.68, p=0.027; -1.63 vs. -2.29, p=0.015, respectively). VAS and ODI showed significant improvement after surgery when fusion was successfully achieved in both groups (p=0.004, p=0.002, HA-DBM group; p=0.012, p=0.03, Autograft group). Conclusion The fusion rates of the hydroxyapatite DBM and Autograft groups were not significantly different. In addition, clinical outcomes were similar between the groups. However, older age and low BMD are risk factors that might

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

    PubMed

    Chen, Kevin S; Park, Paul

    2016-07-01

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

  3. Minimally invasive L5-S1 oblique lumbar interbody fusion with anterior plate.

    PubMed

    Pham, Martin H; Jakoi, Andre M; Hsieh, Patrick C

    2016-07-01

    Lumbar interbody fusion is an important technique for the treatment of degenerative disc disease and degenerative scoliosis. The oblique lumbar interbody fusion (OLIF) establishes a minimally invasive retroperitoneal exposure anterior to the psoas and lumbar plexus. In this video case presentation, the authors demonstrate the techniques of the OLIF at L5-S1 performed on a 69-year-old female with degenerative scoliosis as one component of an overall strategy for her deformity correction. The video can be found here: https://youtu.be/VMUYWKLAl0g . PMID:27364428

  4. Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Jang, Kyoung-Min; Kim, Young-Baeg; Park, Yong-Sook; Nam, Taek-Kyun; Lee, Young-Seok

    2015-01-01

    Objective Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed. PMID:26587189

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

    PubMed Central

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

    2016-01-01

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

  6. Lymphocele formation after anterior lumbar interbody fusion at L4-5. Case report.

    PubMed

    Pee, Yong Hun; Kim, Ki Joon; Choi, Young-Geun; Jeon, Sang Hyeop; Park, Jong Dae; Lee, Sang-Ho

    2007-11-01

    In this report, the authors present the case of patient with a lymphocele in the retroperitoneal area following anterior lumbar interbody fusion at L4-5. A lymphocele is a rare complication of spinal operations, especially lower lumbar spinal surgeries. The authors discuss this complicating factor and describe its features and treatments.

  7. Healing properties of allograft from alendronate-treated animal in lumbar spine interbody cage fusion.

    PubMed

    Xue, Qingyun; Li, Haisheng; Zou, Xuenong; Bünger, Mathias; Egund, Niels; Lind, Martin; Christensen, Finn Bjarke; Bünger, Cody

    2005-04-01

    This study investigated the healing potential of allograft from bisphosphonate-treated animals in anterior lumbar spine interbody fusion. Three levels of anterior lumbar interbody fusion with Brantigan cages were performed in two groups of five landrace pigs. Empty Brantigan cages or cages filled with either autograft or allograft were located randomly at different levels. The allograft materials for the treatment group were taken from the pigs that had been fed with alendronate, 10 mg daily for 3 months. The histological fusion rate was 2/5 in alendronate-treated allograft and 3/5 in non-treated allograft. The mean bone volume was 39% and 37.2% in alendronate-treated or non-treated allograft (NS), respectively. No statistical difference was found between the same grafted cage comparing two groups. The histological fusion rate was 7/10 in all autograft cage levels and 5/10 in combined allograft cage levels. No fusion was found at all in empty cage levels. With the numbers available, no statistically significant difference was found in histological fusion between autograft and allograft applications. There was a significant difference of mean bone volume between autograft (49.2%) and empty cage (27.5%) (P<0.01). In conclusion, this study did not demonstrate different healing properties of alendronate-treated and non-treated allograft for anterior lumbar interbody fusion in pigs. PMID:15248057

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

    PubMed

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

    2016-04-01

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

  9. Posterior interbody fusion using a diagonal cage with unilateral transpedicular screw fixation for lumbar stenosis.

    PubMed

    Zhao, Jian; Zhang, Feng; Chen, Xiaoqing; Yao, Yu

    2011-03-01

    Few reports have described the combined use of unilateral pedicle screw fixation and interbody fusion for lumbar stenosis. We retrospectively reviewed 79 patients with lumbar stenosis. The rationale and effectiveness of unilateral pedicle screw fixation were studied from biomechanical and clinical perspectives, aiming to reduce stiffness of the implant. All patients were operated with posterior interbody fusion using a diagonal cage in combination with unilateral transpedicular screw fixation and had reached the 3-year follow-up interval after operation. The mean operating time was 115 minutes (range=95-150 min) and the mean estimated blood loss was 150 mL (range=100-200 mL). The mean duration of hospital stay was 10 days (range=7-15 days). Clinical outcomes were assessed prior to surgery and reassessed at intervals using Denis' pain and work scales. Fusion status was determined from X-rays and CT scans. At the final follow-up, the clinical results were satisfactory and patients showed significantly improved scores (p<0.01) either on the pain or the work scale. Successful fusion was achieved in all patients. There were no new postoperative radiculopathies, or instances of malpositioned or fractured hardware. Posterior interbody fusion using a diagonal cage with unilateral transpedicular fixation is an effective treatment for decompressive surgery for lumbar stenosis.

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

    PubMed

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

    2016-04-01

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

  11. Clinical Outcomes of Posterior Lumbar Interbody Fusion versus Minimally Invasive Transforaminal Lumbar Interbody Fusion in Three-Level Degenerative Lumbar Spinal Stenosis

    PubMed Central

    Fan, Guoxin; Wu, Xinbo; Yu, Shunzhi; Sun, Qi; Zhang, Hailong; Gu, Xin

    2016-01-01

    The aim of this study was to directly compare the clinical outcomes of posterior lumbar interbody fusion (PLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in three-level lumbar spinal stenosis. This retrospective study involved a total of 60 patients with three-level degenerative lumbar spinal stenosis who underwent MIS-TLIF or PLIF from January 2010 to February 2012. Back and leg visual analog scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) scale were used to assess the pain, disability, and health status before surgery and postoperatively. In addition, the operating time, estimated blood loss, and hospital stay were also recorded. There were no significant differences in back VAS, leg VAS, ODI, SF-36, fusion condition, and complications at 12-month follow-up between the two groups (P > 0.05). However, significantly less blood loss and shorter hospital stay were observed in MIS-TLIF group (P < 0.05). Moreover, patients undergoing MIS-TLIF had significantly lower back VAS than those in PLIF group at 6-month follow-up (P < 0.05). Compared with PLIF, MIS-TLIF might be a prior option because of noninferior efficacy as well as merits of less blood loss and quicker recovery in treating three-level lumbar spinal stenosis. PMID:27747244

  12. Simultaneous Lateral Interbody Fusion and Posterior Percutaneous Instrumentation: Early Experience and Technical Considerations

    PubMed Central

    Drazin, Doniel; Kim, Terrence T.; Johnson, J. Patrick

    2015-01-01

    Lumbar fusion surgery involving lateral lumbar interbody graft insertion with posterior instrumentation is traditionally performed in two stages requiring repositioning. We describe a novel technique to complete the circumferential procedure simultaneously without patient repositioning. Twenty patients diagnosed with worsening back pain with/without radiculopathy who failed exhaustive conservative management were retrospectively reviewed. Ten patients with both procedures simultaneously from a single lateral approach and 10 control patients with lateral lumbar interbody fusion followed by repositioning and posterior percutaneous instrumentation were analyzed. Pars fractures, mobile grade 2 spondylolisthesis, and severe one-level degenerative disk disease were matched between the two groups. In the simultaneous group, avoiding repositioning leads to lower mean operative times: 130 minutes (versus control 190 minutes; p = 0.009) and lower intraoperative blood loss: 108 mL (versus 93 mL; NS). Nonrepositioned patients were hospitalized for an average of 4.1 days (versus 3.8 days; NS). There was one complication in the control group requiring screw revision. Lateral interbody fusion and percutaneous posterior instrumentation are both readily accomplished in a single lateral decubitus position. In select patients with adequately sized pedicles, performing simultaneous procedures decreases operative time over sequential repositioning. Patient outcomes were excellent in the simultaneous group and comparable to procedures done sequentially. PMID:26649303

  13. Failure of a Carbon Fiber–Reinforced Polymer Implant Used for Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Sardar, Zeeshan; Jarzem, Peter

    2013-01-01

    Lumbar interbody fusion is a common procedure owing to the high prevalence of degenerative spinal disorders. During such procedures, carbon fiber–reinforced polymer (CFRP) cages are frequently utilized to fill the void created between adjacent vertebral bodies, to provide mechanical stability, and to carry graft material. Failure of such implants can lead to significant morbidity. We discuss the possible causes leading to the failure of a CFRP cage in a patient with rheumatoid arthritis. Review of a 49-year-old woman who underwent revision anterior lumbar interbody fusion 2 years after posterior instrumentation and transforaminal lumbar interbody fusion at L4–L5 and L5–S1. The patient developed pseudarthrosis at the two previously fused levels with failure of the posterior instrumentation. Revision surgery reveled failure with fragmentation of the CFRP cage at the L5–S1 level. CFRP implants can break if mechanical instability or nonunion occurs in the spinal segments, thus emphasizing the need for optimizing medical management and meticulous surgical technique in achieving stability. PMID:24436878

  14. Failure of a carbon fiber-reinforced polymer implant used for transforaminal lumbar interbody fusion.

    PubMed

    Sardar, Zeeshan; Jarzem, Peter

    2013-12-01

    Lumbar interbody fusion is a common procedure owing to the high prevalence of degenerative spinal disorders. During such procedures, carbon fiber-reinforced polymer (CFRP) cages are frequently utilized to fill the void created between adjacent vertebral bodies, to provide mechanical stability, and to carry graft material. Failure of such implants can lead to significant morbidity. We discuss the possible causes leading to the failure of a CFRP cage in a patient with rheumatoid arthritis. Review of a 49-year-old woman who underwent revision anterior lumbar interbody fusion 2 years after posterior instrumentation and transforaminal lumbar interbody fusion at L4-L5 and L5-S1. The patient developed pseudarthrosis at the two previously fused levels with failure of the posterior instrumentation. Revision surgery reveled failure with fragmentation of the CFRP cage at the L5-S1 level. CFRP implants can break if mechanical instability or nonunion occurs in the spinal segments, thus emphasizing the need for optimizing medical management and meticulous surgical technique in achieving stability.

  15. Simultaneous Lateral Interbody Fusion and Posterior Percutaneous Instrumentation: Early Experience and Technical Considerations.

    PubMed

    Drazin, Doniel; Kim, Terrence T; Johnson, J Patrick

    2015-01-01

    Lumbar fusion surgery involving lateral lumbar interbody graft insertion with posterior instrumentation is traditionally performed in two stages requiring repositioning. We describe a novel technique to complete the circumferential procedure simultaneously without patient repositioning. Twenty patients diagnosed with worsening back pain with/without radiculopathy who failed exhaustive conservative management were retrospectively reviewed. Ten patients with both procedures simultaneously from a single lateral approach and 10 control patients with lateral lumbar interbody fusion followed by repositioning and posterior percutaneous instrumentation were analyzed. Pars fractures, mobile grade 2 spondylolisthesis, and severe one-level degenerative disk disease were matched between the two groups. In the simultaneous group, avoiding repositioning leads to lower mean operative times: 130 minutes (versus control 190 minutes; p = 0.009) and lower intraoperative blood loss: 108 mL (versus 93 mL; NS). Nonrepositioned patients were hospitalized for an average of 4.1 days (versus 3.8 days; NS). There was one complication in the control group requiring screw revision. Lateral interbody fusion and percutaneous posterior instrumentation are both readily accomplished in a single lateral decubitus position. In select patients with adequately sized pedicles, performing simultaneous procedures decreases operative time over sequential repositioning. Patient outcomes were excellent in the simultaneous group and comparable to procedures done sequentially. PMID:26649303

  16. Transforaminal lumbar interbody fusion using unilateral pedicle screws and a translaminar screw

    PubMed Central

    Lee, Sandra; Vaidya, Rahul

    2008-01-01

    Lumbar spinal fusion is advancing with minimally invasive techniques, bone graft alternatives, and new implants. This has resulted in significant reductions of operative time, duration of hospitalization, and higher success in fusion rates. However, costs have increased as many new technologies are expensive. This study was carried out to investigate the clinical outcomes and fusion rates of a low implant load construct of unilateral pedicle screws and a translaminar screw in transforaminal lumbar interbody fusion (TLIF) which reduced the cost of the posterior implants by almost 50%. Nineteen consecutive patients who underwent single level TLIF with this construct were included in the study. Sixteen patients had a TLIF allograft interbody spacer placed, while in three a polyetheretherketone (PEEK) cage was used. Follow-up ranged from 15 to 54 months with a mean of 32 months. A clinical and radiographic evaluation was carried out preoperatively and at multiple time points following surgery. An overall improvement in Oswestry scores and visual analogue scales for leg and back pain (VAS) was observed. Three patients underwent revision surgery due to recurrence of back pain. All patients showed radiographic evidence of fusion from 9 to 26 months (mean 19) following surgery. This study suggests that unilateral pedicle screws and a contralateral translaminar screw are a cheaper and viable option for single level lumbar fusion. PMID:19015896

  17. Complete cage migration/subsidence into the adjacent vertebral body after posterior lumbar interbody fusion.

    PubMed

    Corniola, Marco V; Jägersberg, Max; Stienen, Martin N; Gautschi, Oliver P

    2015-03-01

    A variety of implant-related short and long-term complications after lumbar fusion surgery are recognized. Mid to long-term complications due to cage migration and/or cage subsidence are less frequently reported. Here, we report a patient with a complete cage migration into the superior adjacent vertebral body almost 20 years after the initial posterior lumbar interbody fusion procedure. In this patient, the cage migration/subsidence was clinically silent, but a selective decompression for adjacent segment degenerative lumbar spinal stenosis was performed. We discuss the risk factors for cage migration/subsidence in view of the current literature.

  18. Posterior lumbar interbody fusion using one diagonal fusion cage with transpedicular screw/rod fixation.

    PubMed

    Zhao, Jie; Hou, Tiesheng; Wang, Xinwei; Ma, Shengzhong

    2003-04-01

    Posterior lumbar interbody fusion (PLIF) using threaded cages has gained wide popularity for lumbosacral spinal disease. Our biomechanical tests showed that PLIF using a single diagonal cage with unilateral facetectomy does add a little to spinal stability and provides equal or even higher postoperative stability than PLIF using two posterior cages with bilateral facetectomy. Studies also demonstrated that cages placed using a posterior approach did not cause the same increase in spinal stiffness seen with pedicle screw instrumentation, and we concluded that cages should not be used posteriorly without other forms of fixation. On the other hand, placement of two cages using a posterior approach does have the disadvantage of risk to the bilateral nerve roots. We therefore performed a prospective study to determine whether PLIF can be accomplished by utilizing a single diagonal fusion cage with the application of supplemental transpedicular screw/rod instrumentation. Twenty-seven patients underwent a PLIF using one single fusion cage (BAK, Sulzer Spine-Tech, Minneapolis, MN, USA) inserted posterolaterally and oriented anteromedially on the symptomatic side with unilateral facetectomy and at the same level supplemental fixation with a transpedicular screw/rod system. The internal fixation systems included 12 SOCON spinal systems (Aesculap AG, Germany) and 15 TSRH spinal systems (Medtronic Sofamor Danek, USA). The inclusion criteria were grade 1 to 2 lumbar isthmic spondylolisthesis, lumbar degenerative spondylolisthesis, and recurrent lumbar disc herniations with instability. Patients had at least 1 year of low back pain and/or unilateral sciatica and a severely restricted functional ability in individuals aged 28-55 years. Patients with more than grade 2 spondylolisthesis or adjacent-level degeneration were excluded from the study. Patients were clinically assessed prior to surgery by an independent assessor; they were then reassessed at 1, 3, 6, 12, 18, and 24

  19. Evaluation of ABM/P-15 versus autogenous bone in an ovine lumbar interbody fusion model.

    PubMed

    Sherman, Blake P; Lindley, Emily M; Turner, A Simon; Seim, Howard B; Benedict, James; Burger, Evalina L; Patel, Vikas V

    2010-12-01

    A prospective, randomized study was performed in an ovine model to compare the efficacy of an anorganic bovine-derived hydroxyapatite matrix combined with a synthetic 15 amino acid residue (ABM/P-15) in facilitating lumbar interbody fusion when compared with autogenous bone harvested from the iliac crest. P-15 is a biomimetic to the cell-binding site of Type-I collagen for bone-forming cells. When combined with ABM, it creates the necessary scaffold to initiate cell invasion, binding, and subsequent osteogenesis. In this study, six adult ewes underwent anterior-lateral interbody fusion at L3/L4 and L4/L5 using PEEK interbody rings filled with autogenous bone at one level and ABM/P-15 at the other level and no additional instrumentation. Clinical CT scans were obtained at 3 and 6 months; micro-CT scans and histomorphometry analyses were performed after euthanization at 6 months. Clinical CT scan analysis showed that all autograft and ABM/P-15 treated levels had radiographically fused outside of the rings at the 3-month study time point. Although the clinical CT scans of the autograft treatment group showed significantly better fusion within the PEEK rings than ABM/P-15 at 3 months, micro-CT scans, clinical CT scans, and histomorphometric analyses showed there were no statistical differences between the two treatment groups at 6 months. Thus, ABM/P-15 was as successful as autogenous bone graft in producing lumbar spinal fusion in an ovine model, and it should be further evaluated in clinical studies.

  20. A randomized double-blind prospective study of the efficacy of pulsed electromagnetic fields for interbody lumbar fusions

    SciTech Connect

    Mooney, V. )

    1990-07-01

    A randomized double-blind prospective study of pulsed electromagnetic fields for lumbar interbody fusions was performed on 195 subjects. There were 98 subjects in the active group and 97 subjects in the placebo group. A brace containing equipment to induce an electromagnetic field was applied to patients undergoing interbody fusion in the active group, and a sham brace was used in the control group. In the active group there was a 92% success rate, while the control group had a 65% success rate (P greater than 0.005). The effectiveness of bone graft stimulation with the device is thus established.

  1. Prevalence and Risk Factors of Deep Vein Thrombosis in Patients Undergoing Lumbar Interbody Fusion Surgery

    PubMed Central

    Yang, Si-Dong; Ding, Wen-Yuan; Yang, Da-Long; Shen, Yong; Zhang, Ying-Ze; Feng, Shi-Qing; Zhao, Feng-Dong

    2015-01-01

    Abstract This cross-sectional study was designed to obtain the current prevalence of deep vein thrombosis (DVT) and analyze related risk factors in patients undergoing lumbar interbody fusion. Medical record data were collected from Department of Spinal Surgery, The Third Hospital of Hebei Medical University, between July 2014 and March 2015. Both univariate analysis and binary logistic regression analysis were performed to determine risk factors for DVT. A total of 995 patients were admitted into this study, including 484 men and 511 women, aged from 14 to 89 years old (median 50, IQR 19). The detection rate of lower limb DVT by ultrasonography was 22.4% (223/995) in patients undergoing lumbar interbody fusion. Notably, average VAS (visual analog scale) score in the first 3 days after surgery in the DVT group was more than that in the non-DVT group (Z = −21.69, P < 0.001). The logistic regression model was established as logit P = −13.257 + 0.056∗X1 − 0.243∗X8 + 2.085∗X10 + 0.001∗X12, (X1 = age; X8 = HDL; X10 = VAS; X12 = blood transfusion; x2 = 677.763, P < 0.001). In conclusion, advanced age, high postoperative VAS scores, and blood transfusion were risk factors for postoperative lower limb DVT. As well, the logistic regression model may contribute to an early evaluation postoperatively to ascertain the risk of lower limb DVT in patients undergoing lumbar interbody fusion surgery. PMID:26632909

  2. Transforaminal lumbar interbody fusion versus posterolateral fusion in degenerative lumbar spondylosis

    PubMed Central

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

    2016-01-01

    Abstract Objective: 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. Methods: 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. Results: 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. Conclusions: 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. PMID:27749558

  3. [Anterior cervical fusion with tantalum interbody implants. Clinical and radiological results in a prospective study].

    PubMed

    Vicario, C; Lopez-Oliva, F; Sánchez-Lorente, T; Zimmermann, M; Asenjo-Siguero, J J; Ladero, F; Ibarzábal, A

    2006-04-01

    Anterior cervical discectomy and interbody fusion (ACDF) is a widely accepted surgical technique in the treatment of cervical disc disease. Tantalum cages have been recently introduced in spine surgery for interbody fusion because of the advantages of their mechanical properties. We present the results of a prospective clinical and radiological study on 24 consecutive patients who underwent an ACDF with tantalum cages. Clinical evaluation was assessed preoperatively and after surgery by a questionnaire that included a Visual Analogic Scale (VAS) of neck and arm pain, the Oswestry Disability Index and the Zung Depression Scale. Results were classified by Odom's criteria. Radiological evaluation included flexion-extension X-rays, and changes in distance between spinous processes and Cobb angle were measured. Postoperatively patients were reviewed 3 and 12 months after surgery. A statistical significative improvement in all clinical data was reported. According to Odom's criteria in 75% of patients the results were considered like excellent or good. Only one case of radiological and clinical pseudoarthrosis was confirmed. No significative differences were reported 3 and 12 months after surgery. Tantalum cages are a very promising and usefull alternative among implants available for ACDF. Compatibility with MRI postoperative studies and the unnecessariness of autograft are some of their advantages. PMID:16721480

  4. [Anterior cervical fusion with tantalum interbody implants. Clinical and radiological results in a prospective study].

    PubMed

    Vicario, C; Lopez-Oliva, F; Sánchez-Lorente, T; Zimmermann, M; Asenjo-Siguero, J J; Ladero, F; Ibarzábal, A

    2006-04-01

    Anterior cervical discectomy and interbody fusion (ACDF) is a widely accepted surgical technique in the treatment of cervical disc disease. Tantalum cages have been recently introduced in spine surgery for interbody fusion because of the advantages of their mechanical properties. We present the results of a prospective clinical and radiological study on 24 consecutive patients who underwent an ACDF with tantalum cages. Clinical evaluation was assessed preoperatively and after surgery by a questionnaire that included a Visual Analogic Scale (VAS) of neck and arm pain, the Oswestry Disability Index and the Zung Depression Scale. Results were classified by Odom's criteria. Radiological evaluation included flexion-extension X-rays, and changes in distance between spinous processes and Cobb angle were measured. Postoperatively patients were reviewed 3 and 12 months after surgery. A statistical significative improvement in all clinical data was reported. According to Odom's criteria in 75% of patients the results were considered like excellent or good. Only one case of radiological and clinical pseudoarthrosis was confirmed. No significative differences were reported 3 and 12 months after surgery. Tantalum cages are a very promising and usefull alternative among implants available for ACDF. Compatibility with MRI postoperative studies and the unnecessariness of autograft are some of their advantages.

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

    PubMed

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

    2016-02-01

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

  6. Time-sequential changes of differentially expressed miRNAs during the process of anterior lumbar interbody fusion using equine bone protein extract, rhBMP-2 and autograft

    NASA Astrophysics Data System (ADS)

    Chen, Da-Fu; Zhou, Zhi-Yu; Dai, Xue-Jun; Gao, Man-Man; Huang, Bao-Ding; Liang, Tang-Zhao; Shi, Rui; Zou, Li-Jin; Li, Hai-Sheng; Bünger, Cody; Tian, Wei; Zou, Xue-Nong

    2014-03-01

    The precise mechanism of bone regeneration in different bone graft substitutes has been well studied in recent researches. However, miRNAs regulation of the bone formation has been always mysterious. We developed the anterior lumbar interbody fusion (ALIF) model in pigs using equine bone protein extract (BPE), recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS), and autograft as bone graft substitute, respectively. The miRNA and gene expression profiles of different bone graft materials were examined using microarray technology and data analysis, including self-organizing maps, KEGG pathway and Biological process GO analyses. We then jointly analyzed miRNA and mRNA profiles of the bone fusion tissue at different time points respectively. Results showed that miRNAs, including let-7, miR-129, miR-21, miR-133, miR-140, miR-146, miR-184, and miR-224, were involved in the regulation of the immune and inflammation response, which provided suitable inflammatory microenvironment for bone formation. At late stage, several miRNAs directly regulate SMAD4, Estrogen receptor 1 and 5-hydroxytryptamine (serotonin) receptor 2C for bone formation. It can be concluded that miRNAs play important roles in balancing the inflammation and bone formation.

  7. Anterior column realignment following lateral interbody fusion for sagittal deformity correction.

    PubMed

    Pimenta, Luiz; Fortti, Fernanda; Oliveira, Leonardo; Marchi, Luis; Jensen, Rubens; Coutinho, Etevaldo; Amaral, Rodrigo

    2015-07-01

    Degenerative and iatrogenic diseases may lead to loss of lordosis or even kyphotic thoracolumbar deformity and sagittal misalignment. Traditional surgery with three-column osteotomies is associated with important neurologic risks and postoperative morbidity. In a novel technique, the lateral transpsoas interbody fusion (LTIF) is complemented with the sacrifice of the anterior longitudinal ligament and anterior portion of the annulus followed by the insertion of a hyperlordotic interbody cage. This is a less invasive lateral technique named anterior column realignment (ACR) and aims to correct sagittal misalignment in adult spinal deformity (ASD), with or without the addition of minor posterior osteotomies. In this article, we provide an account of the evolution to the ACR technique, the literature, and the Brazilian experience in the treatment of adult spinal deformity with this novel advanced application of LTIF. In the presence of ASD, the risk-to-benefit ratio of a surgical correction must be evaluated. Less invasive surgical strategies can be alternatives to treat the deformity and provide better quality of life to the patient. ACR is an advanced application of lateral transpsoas approach, up to date has shown to be reliable and effective when used for ASD, and may minimize complications and morbidity from traditional surgical procedures. Long-term follow-up and comparative studies are needed to evaluate real benefit.

  8. Postoperative Flat Back: Contribution of Posterior Accessed Lumbar Interbody Fusion and Spinopelvic Parameters

    PubMed Central

    Kim, Jin Kwon; Kim, Deok Ryeng; Kim, Joo Seung

    2014-01-01

    Objective Posterior accessed lumbar interbody fusion (PALIF) has a clear objective to restore disc height and spinal alignment but surgeons may occasionally face the converse situation and lose lumbar lordosis. We analyzed retrospective data for factors contributing to a postoperative flat back. Methods A total of 105 patients who underwent PALIF for spondylolisthesis and stenosis were enrolled. The patients were divided according to surgical type [posterior lumbar inter body fusion (PLIF) vs. unilateral transforaminal lumbar interbody fusion (TLIF)], number of levels (single vs. multiple), and diagnosis (spondylolisthesis vs. stenosis). We measured perioperative index level lordosis, lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, and disc height in standing lateral radiographs. The change and variance in each parameter and comparative group were analyzed with the paired and Student t-test (p<0.05), correlation coefficient, and regression analysis. Results A significant perioperative reduction was observed in index-level lordosis following TLIF at the single level and in patients with spondylolisthesis (p=0.002, p=0.005). Pelvic tilt and sacral slope were significantly restored following PLIF multilevel surgery (p=0.009, p=0.003). Sacral slope variance was highly sensitive to perioperative variance of index level lordosis in high sacral sloped pelvis. Perioperative variance of index level lordosis was positively correlated with disc height variance (R2=0.286, p=0.0005). Conclusion Unilateral TLIF has the potential to cause postoperative flat back. PLIF is more reliable than unilateral TLIF to restore spinopelvic parameters following multilevel surgery and spondylolisthesis. A high sacral sloped pelvis is more vulnerable to PALIF in terms of a postoperative flat back. PMID:25371781

  9. Multilevel extreme lateral interbody fusion (XLIF) and osteotomies for 3-dimensional severe deformity: 25 consecutive cases

    PubMed Central

    McAfee, Paul C.; Shucosky, Erin; Chotikul, Liana; Salari, Ben; Chen, Lun; Jerrems, Dan

    2013-01-01

    Background This is a retrospective review of 25 patients with severe lumbar nerve root compression undergoing multilevel anterior retroperitoneal lumbar interbody fusion and posterior instrumentation for deformity. The objective is to analyze the outcomes and clinical results from anterior interbody fusions performed through a lateral approach and compare these with traditional surgical procedures. Methods A consecutive series of 25 patients (78 extreme lateral interbody fusion [XLIF] levels) was identified to illustrate the primary advantages of XLIF in correcting the most extreme of the 3-dimensional deformities that fulfilled the following criteria: (1) a minimum of 40° of scoliosis; (2) 2 or more levels of translation, anterior spondylolisthesis, and lateral subluxation (subluxation in 2 planes), causing symptomatic neurogenic claudication and severe spinal stenosis; and (3) lumbar hypokyphosis or flat-back syndrome. In addition, the majority had trunks that were out of balance (central sacral vertical line ≥2 cm from vertical plumb line) or had sagittal imbalance, defined by a distance between the sagittal vertical line and S1 of greater than 3 cm. There were 25 patients who had severe enough deformities fulfilling these criteria that required supplementation of the lateral XLIF with posterior osteotomies and pedicle screw instrumentation. Results In our database, with a mean follow-up of 24 months, 85% of patients showed evidence of solid arthrodesis and no subsidence on computed tomography and flexion/extension radiographs. The complication rate remained low, with a perioperative rate of 2.4% and postoperative rate of 12.2%. The lateral listhesis and anterior spondylolisthetic subluxation were anatomically reduced with minimally invasive XLIF. The main finding in these 25 cases was our isolation of the major indication for supplemental posterior surgery: truncal decompensation in patients who are out of balance by 2 cm or more, in whom posterior spinal

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

    PubMed

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

    2015-08-01

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

  11. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

    PubMed

    Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

    2016-02-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting

  12. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

    PubMed

    Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

    2016-02-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting

  13. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only

    PubMed Central

    Tang, Ming‐xing; Wang, Yu‐xiang; Guo, Chao‐feng; Liu, Jin‐yang

    2016-01-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three‐column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68‐year‐old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone

  14. Digitalized Design of Extraforaminal Lumbar Interbody Fusion: A Computer-Based Simulation and Cadaveric Study

    PubMed Central

    Yang, Mingjie; Zeng, Cheng; Guo, Song; Pan, Jie; Han, Yingchao; Li, Zeqing; Li, Lijun; Tan, Jun

    2014-01-01

    Purpose This study aims to investigate the feasibility of a novel lumbar approach named extraforaminal lumbar interbody fusion (ELIF), a newly emerging minimally invasive technique for treating degenerative lumbar disorders, using a digitalized simulation and a cadaveric study. Methods The ELIF surgical procedure was simulated using the Mimics surgical simulator and included dissection of the superior articular process, dilation of the vertebral foramen, and placement of pedicle screws and a cage. ELIF anatomical measures were documented using a digitalized technique and subsequently validated on fresh cadavers. Results The use of the Mimics allowed for the vivid simulation of ELIF surgical procedures, while the cadaveric study proved the feasibility of this novel approach. ELIF had a relatively lateral access approach that was located 8–9 cm lateral to the median line with an access depth of approximately 9 cm through the intermuscular space. Dissection of the superior articular processes could fully expose the target intervertebral discs and facilitate a more inclined placement of the pedicle screws and cage with robust enhancement. Conclusions According to the computer-based simulation and cadaveric study, it is feasible to perform ELIF. Further research including biomechanical study is needed to prove ELIF has a superior ability to preserve the posterior tension bands of the spinal column, with similar effects on spinal decompression, fixation, and fusion, and if it can enhance post-fusion spinal stability and expedites postoperative recovery. PMID:25157907

  15. One-stage posterior approach and combined interbody and posterior fusion for thoracolumbar spinal tuberculosis with kyphosis in children.

    PubMed

    Zhang, Hong-Qi; Wang, Yu-Xiang; Guo, Chao-Feng; Liu, Jin-Yang; Wu, Jian-Huang; Chen, Jing; Guo, Dai; Tang, Ming-Xing

    2010-11-02

    The goal of this study was to determine the efficacy and feasibility of surgical management of advanced thoracolumbar spine tuberculosis with kyphosis in children in poor general condition with 1-stage posterior decompression, interbody grafts, and posterior instrumentation and fusion. Between 2006 and 2008, 7 children with advanced thoracolumbar spinal tuberculosis accompanied by kyphosis and in poor general condition were treated with 1-stage posterior decompression, interbody grafts, and posterior instrumentation and fusion followed by chemotherapy. Mean follow-up was 34 months (range, 27-42 months). Patients were evaluated pre- and postoperatively for erythrocyte sedimentation rate (ESR), neurological status, pain, spinal canal compromise, and kyphotic angle. Spinal tuberculosis was completely cured and the grafted bones fused in all 7 patients. There was no recurrence of the disease in any patient at final follow-up. In all patients, ESR was normal within 3 months, Frankel neurological classification improved, and pain relief was obtained. Average canal compromise was 52.57% (range, 35%-75%) preoperatively and 9.86% (range, 0%-19%) postoperatively. Average preoperative kyphosis was 37.9°, which decreased to 5.4° postoperatively. There was no significant loss of correction at last follow-up. Our results show that 1-stage posterior decompression, interbody grafts, and posterior instrumentation and fusion followed by chemotherapy is an alternative treatment for children with advanced thoracolumbar spinal tuberculosis and in poor general condition.

  16. Minimally Invasive Direct Thoracic Interbody Fusion (MIS-DTIF): Technical Notes of a Single Surgeon Study

    PubMed Central

    Abbasi, Hamid

    2016-01-01

    Background Minimally invasive direct thoracic interbody fusion (MIS-DTIF) is a new single surgeon procedure for fusion of the thoracic vertebrae below the scapula (T6/7) to the thoracolumbar junction. In this proof of concept study, we describe the surgical technique for MIS-DTIF and report our experience and the perioperative outcomes of the first four patients who underwent this procedure. Study design/setting In this study we attempt to establish the safety and efficacy of MIS-DTIF. We have performed MIS-DTIF on six spinal levels in four patients with degenerative disk disease or disk herniation. We recorded surgery time, blood loss, fluoroscopy time, complications, and patient-reported pain. Methods Throughout the MIS-DTIF procedure, the surgeon is aided by biplanar fluoroscopic imaging and electrophysiological monitoring. The surgeon approaches the spine with a series of gentle tissue dilations and inserts a working tube that establishes a direct connection from the outside of the skin to the disk space. Through this working tube, the surgeon performs a discectomy and inserts an interbody graft or cage. The procedure is completed with minimally invasive (MI) posterior pedicle screw fixation. Results For the single level patients the mean blood loss was 90 ml, surgery time 43 minutes, fluoroscopy time 293 seconds, and hospital stay two days. For the two-level surgeries, the mean blood loss was 27 ml, surgery time 61 minutes, fluoroscopy time 321 seconds, and hospital stay three days. We did not encounter any clinically significant complications. Thirty days post-surgery, the patients reported a statistically significant reduction of 5.3 points on a 10-point sliding pain scale. Conclusions MIS-DTIF with pedicle screw fixation is a safe and clinically effective procedure for fusions of the thoracic spine. The procedure is technically straightforward and overcomes many of the limitations of the current minimally invasive (MI) approaches to the thoracic spine. MIS

  17. A novel synthetic material for spinal fusion: a prospective clinical trial of porous bioactive titanium metal for lumbar interbody fusion.

    PubMed

    Fujibayashi, Shunsuke; Takemoto, Mitsuru; Neo, Masashi; Matsushita, Tomiharu; Kokubo, Tadashi; Doi, Kenji; Ito, Tatsuya; Shimizu, Akira; Nakamura, Takashi

    2011-09-01

    The objective of this study was to establish the efficacy and safety of porous bioactive titanium metal for use in a spinal fusion device, based on a prospective human clinical trial. A high-strength spinal interbody fusion device was manufactured from porous titanium metal. A bioactive surface was produced by simple chemical and thermal treatment. Five patients with unstable lumbar spine disease were treated surgically using this device in a clinical trial approved by our Ethics Review Committee and the University Hospital Medical Information Network. Clinical and radiological results were reported at the minimum follow-up period of 1 year. The optimal mechanical strength and interconnected structure of the porous titanium metal were adjusted for the device. The whole surface of porous titanium metal was treated uniformly and its bioactive ability was confirmed before clinical use. Successful bony union was achieved in all cases within 6 months without the need for autologous iliac crest bone grafting. Two specific findings including an anchoring effect and gap filling were evident radiologically. All clinical parameters improved significantly after the operation and no adverse effects were encountered during the follow-up period. Although a larger and longer-term follow-up clinical study is mandatory to reach any firm conclusions, the study results show that this porous bioactive titanium metal is promising material for a spinal fusion device.

  18. Instrumented transforaminal lumbar interbody fusion in surgical treatment of recurrent disc herniation

    PubMed Central

    Omidi-Kashani, Farzad; Ghayem Hasankhani, Ebrahim; Noroozi, Hamid Reza

    2014-01-01

    Background: The incidence of recurrence in patients undergoing primary discectomy due to lumbar disc herniation (LDH), is regularly reported as 5-15%. In this study we aimed to evaluate surgical outcome of instrumented transforaminal lumbar interbody fusion (TLIF) in the patients suffering from recurrent LDH. Methods: We retrospectively studied 51 patients (30 female, 21 male) from August 2007 to October 2011. The mean age and follow-up of the patients was 46.4±14.8 (ranged; 29-77 years old) and 31.4±6.8 (ranged; 25-50 months), respectively. Clinical improvement was assessed by Oswestry Disability Index (ODI), visual analogue scale (VAS), and subjective satisfaction rate, while fusion was appraised radiologically. Data analysis was by one sample Kolmogorov-Smirnov, paired t, and Mann-Whitney tests. Results: Surgery could significantly improve mean leg and lumbar VAS and ODI from preoperative 7.4±2.5, 7.8±3.1, and 72.1±21.5 to postoperative 3.4±3.6, 3.5±2.6, and 27.5±18.0, respectively at the last follow-up visit. Subjective satisfaction rate was excellent in 24 patients (47.1%), good in 14 (27.5%), fair 11 (21.6%), and poor in two (3.9%). We had one patient with iatrogenic partial L5 nerve root injury and one with unknown late onset refractory postoperative back pain. Fusion rate was 100% and instrument failure was nil. Conclusion: In surgical treatment of the patients with recurrent LDH, bilaterally instrumented TLIF is a relatively safe and effective procedure and can be associated with least instrument failure and highest fusion rate while no postoperative bracing is also needed. PMID:25679003

  19. Lifestyle-Related Diseases Affect Surgical Outcomes after Posterior Lumbar Interbody Fusion.

    PubMed

    Sakaura, Hironobu; Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

    2016-02-01

    Study Design Retrospective study. Objective Hyperlipidemia (HL) and hypertension (HT) lead to systemic atherosclerosis. Not only atherosclerosis but also bone fragility and/or low bone mineral density result from diabetes mellitus (DM) and chronic kidney disease (CKD). The purpose of this study was to examine whether these lifestyle-related diseases affected surgical outcomes after posterior lumbar interbody fusion (PLIF). Methods The subjects comprised 122 consecutive patients who underwent single-level PLIF for degenerative lumbar spinal disorders. The clinical results were assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2 years postoperatively. The fusion status was graded as union in situ, collapsed union, or nonunion at 2 years after surgery. The abdominal aorta calcification (AAC) score was assessed using preoperative lateral radiographs of the lumbar spine. Results HL did not significantly affect the JOA score recovery rate. On the other hand, HT and CKD (stage 3 to 4) had a significant adverse effect on the recovery rate. The recovery rate was also lower in the DM group than in the non-DM group, but the difference was not significant. The AAC score was negatively correlated with the JOA score recovery rate. The fusion status was not significantly affected by HL, HT, DM, or CKD; however, the AAC score was significantly higher in the collapsed union and nonunion group than in the union in situ group. Conclusions At 2 years after PLIF, the presence of HT, CKD, and AAC was associated with significantly worse clinical outcomes, and advanced AAC significantly affected fusion status. PMID:26835195

  20. Treatment of Symptomatic Lumbar Disc Degeneration with the VariLift-L Interbody Fusion System: Retrospective Review of 470 Cases

    PubMed Central

    Neely, Warren F.; Fichtel, Frank; del Monaco, Diana Cardenas

    2016-01-01

    Background Many first generation stand-alone fusion cages required endplate decortication and surgical impaction during the procedure resulting in segmental subsidence, implant migration and loss of lordosis postoperatively. The primary objective of this study was to evaluate radiographically, in a large series of patients, whether engineering and design modifications incorporated in a specific stand-alone, expandable interbody fusion device (VariLift®-L) adequately addressed previously recognized deficiencies of stand-alone interbody cages. Methods In this retrospective chart review of 470 patients (642 treated levels), we evaluated radiographic evidence of fusion, subsidence and migration following a one- or two-level PLIF procedure utilizing this stand-alone expandable interbody fusion device. A secondary objective was to corroborate the low morbidity and symptomatic improvements achieved with previous interbody cage devices used to treat symptomatic disc degeneration. Results The average postoperative followup was 3.9 ± 1.8 years and a solid fusion rate of 94% was achieved among patients with ≥ 9 months of radiographic followup. Subsidence > 3 mm was noted at 10 levels with no cases of device migration. Composite back pain severity scores improved from 8.5 ± 1.5 preoperatively to 0.8 ± 1.5 at final followup (p<0.001) and 94% of patients met or exceeded the minimal clinical important difference of 3.8 points. Eighteen patients required reoperation following the index procedure; 16 of these patients were treated for adjacent segment disease. Conclusions (LOE) The VariLift-L device has excellent clinical and technical performance characteristics, providing adequate stabilization of the anterior column without the need for supplemental posterior instrumentation. Level of Evidence IV. IRB Approval: Expedited Federal Register Categories 5& 7: Methodist IRB 3/30/2011; Informed Consent statement: retrospective data collection, patients signed consent forms

  1. Reduction in adjacent-segment degeneration after multilevel posterior lumbar interbody fusion with proximal DIAM implantation.

    PubMed

    Lu, Kang; Liliang, Po-Chou; Wang, Hao-Kuang; Liang, Cheng-Loong; Chen, Jui-Sheng; Chen, Tai-Been; Wang, Kuo-Wei; Chen, Han-Jung

    2015-08-01

    OBJECT Multilevel long-segment lumbar fusion poses a high risk for future development of adjacent-segment degeneration (ASD). Creating a dynamic transition zone with an interspinous process device (IPD) proximal to the fusion has recently been applied as a method to reduce the occurrence of ASD. The authors report their experience with the Device for Intervertebral Assisted Motion (DIAM) implanted proximal to multilevel posterior lumbar interbody fusion (PLIF) in reducing the development of proximal ASD. METHODS This retrospective study reviewed 91 cases involving patients who underwent 2-level (L4-S1), 3-level (L3-S1), or 4-level (L2-S1) PLIF. In Group A (42 cases), the patients received PLIF only, while in Group B (49 cases), an interspinous process device, a DIAM implant, was put at the adjacent level proximal to the PLIF construct. Bone resection at the uppermost segment of the PLIF was equally limited in the 2 groups, with preservation of the upper portion of the spinous process/lamina and the attached supraspinous ligament. Outcome measures included a visual analog scale (VAS) for low-back pain and leg pain and the Oswestry Disability Index (ODI) for functional impairment. Anteroposterior and lateral flexion/extension radiographs were used to evaluate the fusion status, presence and patterns of ASD, and mobility of the DIAM-implanted segment. RESULTS Solid interbody fusion without implant failure was observed in all cases. Radiographic ASD occurred in 20 (48%) of Group A cases and 3 (6%) of Group B cases (p < 0.001). Among the patients in whom ASD was identified, 9 in Group A and 3 in Group B were symptomatic; of these patients, 3 in Group A and 1 in Group B underwent a second surgery for severe symptomatic ASD. At 24 months after surgery, Group A patients fared worse than Group B, showing higher mean VAS and ODI scores due to symptoms related to ASD. At the final follow-up evaluations, as reoperations had been performed to treat symptomatic ASD in some

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

    PubMed

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

    2016-01-01

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

  3. Computer-assisted Minimally Invasive Posterior Lumbar Interbody Fusion without C-arm Fluoroscopy.

    PubMed

    Tanaka, Masato; Sugimoto, Yoshiharu; Arataki, Shinya; Takigawa, Tomoyuki; Ozaki, Toshifumi

    2016-01-01

    Computer-assisted spinal surgery is becoming more common; however, this is the first technical report to describe the technique of minimally invasive spinal posterior lumbar interbody fusion (MIS-PLIF) without using C-arm fluoroscopy. The authors report 2 years of follow-up of a 49-year-old female patient with L4 degenerative spondylolisthesis. The patient suffered from low back pain and intermittent claudication for more than 6 years. The authors performed computer-assisted MIS-PLIF without C-arm fluoroscopy. Instead, O-arm® navigation, the use of which reduces radiation exposure to patients as well as others in the operating room, was employed. Surgery was successful, and correct lumbar alignment was maintained. She had neither neurological deficits nor low back pain at her 12-month final follow-up. In conclusion, computer-assisted MIS-PLIF without C-arm fluoroscopy is a useful technique that reduces radiation exposure to the surgeon and operating room staff.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    2016-01-01

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

  7. 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

  8. Preliminary Results of Bioactive Amniotic Suspension with Allograft for Achieving One and Two-Level Lumbar Interbody Fusion

    PubMed Central

    Kerr, Eubulus J.; Utter, Philip A.; Cavanaugh, David A.; Frank, Kelly A.; Moody, Devan; McManus, Brian; Stone, Marcus B.

    2016-01-01

    Background Bone graft material for lumbar fusion was historically autologous bone graft (ABG). In recent years alternatives such as allograft, demineralized bone matrix (DBM), ceramics, and bone morphogenetic protein (BMP) have gained favor, although the complications of these are not fully understood. Bioactive amniotic suspension (BAS) with allograft is a new class of material derived from human amniotic tissue. Methods Eligible patients receiving a one or two level lumbar interbody fusion with Nucel, a BAS with allograft, were contacted and scheduled for a mininmim 12 month follow-up visit. Patients were evaluated for fusion using CT's and plain radiographs. Clincal outcomes, including ODI, VAS back and leg were collected, as well as comorbidities including BMI, smoking status, diabetes and previous lumbar surgery. Results One-level patients (N=38) were 71.1% female with mean age of 58.4 ± 12.7 and mean BMI of 30.6 ± 6.08. Two-level patients (N=34) were 58.8% female with mean age of 49.3 ±10.9 and mean BMI of 30.1 ± 5.82. Kinematic fusion was achieved in 97.4% of one-level patients and 100% of two-level patients. Baseline comorbidities were present in 89.5% of one-level patients and 88.2% of two-level patients. No adverse events related to BAS were reported in this study. Conclusion Fusion status is evaluated with many different biologics and varying methods in the literature. BAS with allograft in this study demonstrated high fusion rates with no complications within a largely comorbid population. Although a small population, BAS with allograft results were encouraging for one and two-level lumbar interbody fusion in this study. Further prospective studies should be conducted to investigate safety and efficacy in a larger population. PMID:27162714

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

    PubMed Central

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

    2016-01-01

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

  10. The concave versus convex approach for minimally invasive lateral lumbar interbody fusion for thoracolumbar degenerative scoliosis.

    PubMed

    Scheer, Justin K; Khanna, Ryan; Lopez, Alejandro J; Fessler, Richard G; Koski, Tyler R; Smith, Zachary A; Dahdaleh, Nader S

    2015-10-01

    We retrospectively reviewed patient charts to compare the approach-related (convex versus concave) neurological complications and magnitude of correction in patients undergoing lateral lumbar interbody fusion (LLIF). It is yet to be quantitatively determined if correction of adult degenerative scoliosis from either side of the curve apex using a LLIF results in a reduction in complications and/or improved corrective ability. The inclusion criteria for this study were patients who underwent a LLIF for adult degenerative thoracolumbar scoliosis and had the LLIF prior to any other supplemental procedures. Patients were grouped based on the approach toward the curve apex concavity (CAVE) or the convexity (VEX). Standard coronal and sagittal radiographic measurements were made. Neurological complications and reoperation indications were also recorded. We included 32 patients for review (CAVE: 17; VEX: 15) with a mean age of 65.5 years±a standard deviation of 10.2, and mean follow-up of 17.0 months±15.7. There were eight postoperative neurological complications in eight patients (25.0%), and seven reoperations for six patients (18.8%; CAVE: 4/17 [23.5%]; VEX: 2/15 [13.3%]). The CAVE group had 6/17 neurological complications (35.3%; four ipsilateral and two contralateral to approach side) and VEX had 2/15 (13.3%; one ipsilateral and one bilateral to approach side; p>0.05). All patients significantly improved in the mean regional and segmental Cobb angles (p<0.05), except for T11-T12 (p>0.05). There were no significant differences between the groups for any of the radiographic parameters measured (p>0.05). Approaching the curve apex from either the concave or convex side resulted in significant improvements. The concave approach was associated with more postoperative neurological complications.

  11. Predisposing Factors for Intraoperative Endplate Injury of Extreme Lateral Interbody Fusion

    PubMed Central

    Kanemura, Tokumi; Yamaguchi, Hidetoshi; Segi, Naoki; Ouchida, Jun

    2016-01-01

    Study Design Retrospective study. Purpose To compare intraoperative endplate injury cases and no injury cases in consecutive series and to identify predisposing factors for intraoperative endplate injury. Overview of Literature Unintended endplate violation and subsequent cage subsidence is an intraoperative complication of extreme lateral interbody fusion (XLIF). It is still unknown whether it is derived from inexperienced surgical technique or patients' inherent problems. Methods Consecutive patients (n=102; mean age, 69.0±0.8 years) underwent XLIF at 201 levels at a single institute. Preoperative and immediately postoperative radiographs were compared and cases with intraoperative endplate injury were identified. Various parameters were reviewed in each patient and compared between the injury and no injury groups. Results Twenty one levels (10.4%) had signs of intraoperative endplate injury. The injury group had a significantly higher rate of females (p=0.002), lower bone mineral density (BMD) (p=0.02), higher rate of polyetheretherketone as cage material (p=0.04), and taller cage height (p=0.03) compared with the no injury group. Multivariate analysis indicated that a T-score of BMD as a negative (odds ratio, 0.52; 95% confidence interval, 0.27–0.93; p=0.03) and cage height as a positive (odds ratio, 1.84; 95% confidence interval, 1.01–3.17; p=0.03) were predisposing factors for intraoperative endplate injury. Conclusions Intraoperative endplate injury is correlated significantly with reduced BMD and taller cage height. Precise evaluation of bone quality and treatment for osteoporosis might be important and care should be taken not to choose excessively taller cage. PMID:27790319

  12. Use of 3D CT-based navigation in minimally invasive lateral lumbar interbody fusion.

    PubMed

    Joseph, Jacob R; Smith, Brandon W; Patel, Rakesh D; Park, Paul

    2016-09-01

    OBJECTIVE Lateral lumbar interbody fusion (LLIF) is an increasingly popular technique used to treat degenerative lumbar disease. The technique of using an intraoperative cone-beam CT (iCBCT) and an image-guided navigation system (IGNS) for LLIF cage placement has been previously described. However, other than a small feasibility study, there has been no clinical study evaluating its accuracy or safety. Therefore, the purpose of this study was to evaluate the accuracy and safety of image-guided spinal navigation in LLIF. METHODS An analysis of a prospectively acquired database was performed. Thirty-one consecutive patients were identified. Accuracy was initially determined by comparison of the planned trajectory of the IGNS with post-cage placement intraoperative fluoroscopy. Accuracy was subsequently confirmed by postprocedural CT and/or radiography. Cage placement was graded based on a previously described system separating the disc space into quarters. RESULTS The mean patient age was 63.9 years. A total of 66 spinal levels were treated, with a mean of 2.1 levels (range 1-4) treated per patient. Cage placement was noted to be accurate using IGNS in each case, as confirmed with intraoperative fluoroscopy and postoperative imaging. Sixty-four (97%) cages were placed within Quarters 1 to 2 or 2 to 3, indicating placement of the cage in the anterior or middle portions of the disc space. There were no instances of misguidance by IGNS. There was 1 significant approach-related complication (psoas muscle abscess) that required intervention, and 8 patients with transient, mild thigh paresthesias or weakness. CONCLUSIONS LLIF can be safely and accurately performed utilizing iCBCT and IGNS. Accuracy is acceptable for multilevel procedures. PMID:27104283

  13. Comparison of the Dynesys Dynamic Stabilization System and Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease

    PubMed Central

    Zhang, Yang; Shan, Jian-Lin; Liu, Xiu-Mei; Li, Fang; Guan, Kai; Sun, Tian-Sheng

    2016-01-01

    Background There have been few studies comparing the clinical and radiographic outcomes between the Dynesys dynamic stabilization system and posterior lumbar interbody fusion (PLIF). The objective of this study is to compare the clinical and radiographic outcomes of Dynesys and PLIF for lumbar degenerative disease. Methods Of 96 patients with lumbar degenerative disease included in this retrospectively analysis, 46 were treated with the Dynesys system and 50 underwent PLIF from July 2008 to March 2011. Clinical and radiographic outcomes were evaluated. We also evaluated the occurrence of radiographic and symptomatic adjacent segment degeneration (ASD). Results The mean follow-up time in the Dynesys group was 53.6 ± 5.3 months, while that in the PLIF group was 55.2 ± 6.8 months. At the final follow-up, the Oswestry disability index and visual analogue scale score were significantly improved in both groups. The range of motion (ROM) of stabilized segments in Dynesys group decreased from 7.1 ± 2.2° to 4.9 ± 2.2° (P < 0.05), while that of in PLIF group decreased from 7.3 ± 2.3° to 0° (P < 0.05). The ROM of the upper segments increased significantly in both groups at the final follow-up, the ROM was higher in the PLIF group. There were significantly more radiographic ASDs in the PLIF group than in the Dynesys group. The incidence of complications was comparable between groups. Conclusions Both Dynesys and PLIF can improve the clinical outcomes for lumbar degenerative disease. Compared to PLIF, Dynesys stabilization partially preserves the ROM of the stabilized segments, limits hypermobility in the upper adjacent segment, and may prevent the occurrence of ASD. PMID:26824851

  14. Transforaminal lumbar interbody fusion using one diagonal fusion cage with unilateral pedicle screw fixation for treatment of massive lumbar disc herniation

    PubMed Central

    Zhao, Chang-Qing; Ding, Wei; Zhang, Kai; Zhao, Jie

    2016-01-01

    Background: Large lumbar or lumbosacral (LS) disc herniations usually expand from the paramedian space to the neuroforamen and compress both the transversing (lower) and the exiting (upper) nerve roots, thus leading to bi-radicular symptoms. Bi-radicular involvement is a statistically significant risk factor for poor outcome in patients presenting with far lateral or foraminal disc herniation after facet preserving microdecompression. There is evidence showing that patients suffering from large lumbar disc herniations treated with interbody fusion have significant superior results in comparison with those who received a simple discectomy. We report our experiences on managing large LS disc herniation with bi-radicular symptoms by transforaminal lumbar interbody fusion (TLIF) using one diagonal fusion cage with unilateral pedicle screw/rod fixation. Materials and Methods: Twenty-three patients who suffered from single level lumbar or LS disc herniation with bi-radicular symptoms treated with unilateral decompression and TLIF using one diagonal fusion cage with ipsilateral pedicle screw/rod fixation operated between January 2005 and December 2009, were included in this study. Operation time and blood loss were recorded. The pain and disability status were pre- and postoperatively evaluated by the visual analog score (VAS) and Oswestry Disability Index (ODI). Interbody bony fusion was detected by routine radiographs and computed tomography scan. Adjacent segment degeneration was detected by routine radiographs and magnetic resonance imaging examination. Overall outcomes were categorized according to modified Macnab classification. Results: The patients were followed up for an average of 44.7 months. Pain relief in the VAS and improvement of the ODI were significant after surgery and at final followup. No severe complications occurred during hospital stay. Interbody bony fusion was achieved in every case. No cage retropulsion was observed, while 3 cases experienced

  15. Do Trunk Muscles Affect the Lumbar Interbody Fusion Rate?: Correlation of Trunk Muscle Cross Sectional Area and Fusion Rates after Posterior Lumbar Interbody Fusion Using Stand-Alone Cage

    PubMed Central

    Choi, Man Kyu; Park, Bong Jin; Park, Chang Kyu; Kim, Sung Min

    2016-01-01

    Objective Although trunk muscles in the lumbar spine preserve spinal stability and motility, little is known about the relationship between trunk muscles and spinal fusion rate. The aim of the present study is to evaluate the correlation between trunk muscles cross sectional area (MCSA) and fusion rate after posterior lumbar interbody fusion (PLIF) using stand-alone cages. Methods A total of 89 adult patients with degenerative lumbar disease who were performed PLIF using stand-alone cages at L4–5 were included in this study. The cross-sectional area of the psoas major (PS), erector spinae (ES), and multifidus (MF) muscles were quantitatively evaluated by preoperative lumbar magnetic resonance imaging at the L3–4, L4–5, and L5–S1 segments, and bone union was evaluated by dynamic lumbar X-rays. Results Of the 89 patients, 68 had bone union and 21 did not. The MCSAs at all segments in both groups were significantly different (p<0.05) for the PS muscle, those at L3–4 and L4–5 segments between groups were significantly different (p=0.048, 0.021) for the ES and MF muscles. In the multivariate analysis, differences in the PS MCSA at the L4–5 and L5–S1 segments remained significant (p=0.048, 0.043 and odds ratio=1.098, 1.169). In comparison analysis between male and female patients, most MCSAs of male patients were larger than female's. Fusion rates of male patients (80.7%) were higher than female's (68.8%), too. Conclusion For PLIF surgery, PS muscle function appears to be an important factor for bone union and preventing back muscle injury is essential for better fusion rate. PMID:27226860

  16. Posterior convex release and interbody fusion for thoracic scoliosis: technical note.

    PubMed

    Mac-Thiong, Jean-Marc; Asghar, Jahangir; Parent, Stefan; Shufflebarger, Harry L; Samdani, Amer; Labelle, Hubert

    2016-09-01

    Anterior release and fusion is sometimes required in pediatric patients with thoracic scoliosis. Typically, a formal anterior approach is performed through open thoracotomy or video-assisted thoracoscopic surgery. The authors recently developed a technique for anterior release and fusion in thoracic scoliosis referred to as "posterior convex release and interbody fusion" (PCRIF). This technique is performed via the posterior-only approach typically used for posterior instrumentation and fusion and thus avoids a formal anterior approach. In this article the authors describe the technique and its use in 9 patients-to prevent a crankshaft phenomenon in 3 patients and to optimize the correction in 6 patients with a severe thoracic curve showing poor reducibility. After Ponte osteotomies at the levels requiring anterior release and fusion, intervertebral discs are approached from the convex side of the scoliosis. The annulus on the convex side of the scoliosis is incised from the lateral border of the pedicle to the lateral annulus while visualizing and protecting the pleura and spinal cord. The annulus in contact with the pleura and the anterior longitudinal ligament are removed before completing the discectomies and preparing the endplates. The PCRIF was performed at 3 levels in 4 patients and at 4 levels in 5 patients. Mean correction of the main thoracic curve, blood loss, and length of stay were 74.9%, 1290 ml, and 7.6 days, respectively. No neurological deficit, implant failure, or pseudarthrosis was observed at the last follow-up. Two patients had pleural effusion postoperatively, with 1 of them requiring placement of a chest tube. One patient had pulmonary edema secondary to fluid overload, while another patient underwent reoperation for a deep wound infection 3 weeks after the initial surgery. The technique is primarily indicated in skeletally immature patients with open triradiate cartilage and/or severe scoliosis. It can be particularly useful if there is

  17. Transforaminal lumbar interbody fusion rates in patients using a novel titanium implant and demineralized cancellous allograft bone sponge

    PubMed Central

    Girasole, Gerard; Muro, Gerard; Mintz, Abraham; Chertoff, Jason

    2013-01-01

    Background Transforaminal lumbar interbody fusion (TLIF) with grafting and implant options like iliac crest bone graft (ICBG), recombinant bone morphogenetic protein (rhBMP), and polyetheretherketone (PEEK) cages have been reported to achieve extremely high fusion rates. Unfortunately, these options have also been frequently cited in the literature as causing postoperative morbidity and complications at a high cost. Knowing this, we sought to investigate TLIF using an acid-etched, roughened titanium cage that upregulates osteogenesis to see if similar fusion rates to those cited for ICBG, rhBMP, and PEEK cages could be safely achieved with minimal morbidity and complications. Materials and methods A radiographic fusion study of 82 patients who underwent TLIF using an acid-etched, roughened titanium cage with demineralized cancellous bone graft was conducted. Fusion was assessed and graded by an independent radiologist using computed tomography scan with sagittal and coronal reconstructions. Results Fusion rates at 6 months were 41 of 44 (93.2%) and at 12 months were 37 of 38 (97.4%). There were no radiographic device-related complications. Conclusions TLIF with an acid-etched, roughened titanium cage filled with a decalcified bone graft achieved similar fusion rates to historical controls using ICBG, rhBMP, and PEEK. PMID:25580378

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

    PubMed Central

    Zhou, Yue; Li, Changqing; Liu, Huan

    2015-01-01

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

  19. Imaging Anatomical Research on the Operative Windows of Oblique Lumbar Interbody Fusion

    PubMed Central

    Liang, Yong; Zhang, Hong; Wang, Haoming; Guo, Congtao; Pu, Xiaobing; Zhang, Chengmin; Wang, Liyuan; Wang, Jian; Lv, Yingwen; Ren, Zhoukui; Zhou, Qiang; Deng, Zhongliang

    2016-01-01

    To provide applied anatomical evidence of the preoperative assessment of oblique lumbar interbody fusion (OLIF), the anatomical parameters of the OLIF operative window were observed through computed tomography angiography (CTA). We selected imaging data from 60 adults (30 males, 30 females) who underwent abdominal CTA and T12-S1 vertebral computed tomography (CT) with three-dimensional reconstruction. The OLIF operative windows at the L1-2, L2-3, L3-4, L4-5 and L5-S1 levels were as follows: the vascular window, bare window, psoas major window, ideal operative window, and actual operative window. Each level's actual operative window was statistically analyzed based on an actual operative window of <1 cm and ≥1 cm. The vascular window was largest at L4-5 (1.72 ± 0.58 cm). The bare window was largest at L5-S1 (1.59 ± 0.93 cm) and smallest at L3-4 (1.37 ± 0.51 cm). The psoas major window was largest at L3-4 (1.14 ± 0.35 cm) and smallest at L1-2 (0.41 ± 0.34 cm). The ideal operative window was largest at L4-5 (3.74 ± 0.36 cm) and smallest at L1-2 (3.23 ± 0.30 cm). The actual operative window was largest at L3-4, followed by L2-3, L4-5, L1-2, and L5-S1, which were 2.51 ± 0.56 cm, 2.28 ± 0.54 cm, 2.01 ± 0.74 cm, 1.80 ± 0.45 cm and 1.59 ± 0.93 cm, respectively (P = 0.000), and the percentages of the actual surgical window were 69%, 66%, 53%, 56% and 43%, respectively. The actual surgical window was <1 cm in 2 cases at L1-2 (3.3%), 4 cases at L4-5 (6.7%), and 17 cases at L5-S1 (28.3%) (11 males and 6 females). The regional anatomy of each level related to OLIF has its own peculiarities, and not all levels are suitable for OLIF. Before OLIF surgery, surgeons should analyze the imaging anatomy and select the appropriate surgical procedures. PMID:27685646

  20. [Results of operative treatment thoraco-lumbar fractures by posterior lumbar interbody fusion, Daniaux reconstruction or combination of both methods].

    PubMed

    Wegłowski, Robert; Godlewski, Piotr; Blacha, Jan; Kołodziej, Robert; Mazurkiewicz, Tomasz

    2011-01-01

    The aim of the study was to compare clinical and radiological results of treatment thoraco-lumbar spine fractures by short segment transpedicular stabilization accompanied by three techniques of reconstruction: posterior lumbar interbody fusion, vertebral body Daniaux reconstruction and combination of both methods. AO system was used to classify the fractures. Frankel's grade system was used for assessment of neurological deficit on admission and subsequently in the postoperative and follow-up period. The height of the fractured vertebral body and angle of segmental kyphotic deformation was measured on lateral X-ray pre- and post-operatively and at last follow-up. To the retrospective analysis we included 167 patients operated in the Orthopaedic and Traumatology Department, Medical University of Lublin in years 1998-2007. Posterior lumbar interbody fusion was performed in 69 patients (41%), isolated vertebral body Daniaux reconstruction in 82 patients (49%) and combination of both methods was performed in 16 patients (10%). The follow-up period has ranged from 3 to 13 years (mean 6.9 years). The most common type of the fracture was a B type (104 patients -62%), followed by type A (43 patients--26%), and type C (20--patients 12%). The neurological deficit was present in 80 patients. The postoperative neurological improvement was noticed in 37 patients (46%), whereas in 46 patients (54%) neurological status has not changed after the treatment. From 87 patients without neurological symptoms, we observed postoperatively contemporary neurological complications in 11 (12.6%) cases. The biggest correction of fractured vertebral height (mean 0.15) and correction of segmental kyphotic deformity (mean 6.3 degrees) we have noticed in the group of isolated vertebralbody Daniaux reconstruction with use of bone grafts. However in every group of patients we observed significant loss of correction during follow-up period. At the latest follow-up assessment there were no

  1. The influence of cage positioning and cage type on cage migration and fusion rates in patients with monosegmental posterior lumbar interbody fusion and posterior fixation

    PubMed Central

    Abbushi, Alexander; Čabraja, Mario; Thomale, Ulrich-Wilhelm; Woiciechowsky, Christian

    2009-01-01

    In posterior lumbar interbody fusion, cage migrations and lower fusion rates compared to autologous bone graft used in the anterior lumbar interbody fusion procedure are documented. Anatomical and biomechanical data have shown that the cage positioning and cage type seem to play an important role. Therefore, the aim of the present study was to evaluate the impact of cage positioning and cage type on cage migration and fusion. We created a grid system for the endplates to analyze different cage positions. To analyze the influence of the cage type, we compared “closed” box titanium cages with “open” box titanium cages. This study included 40 patients with 80 implanted cages. After pedicle screw fixation, 23 patients were treated with a “closed box” cage and 17 patients with an “open box” cage. The follow-up period averaged 25 months. Twenty cages (25%) showed a migration into one vertebral endplate of <3 mm and four cages (5%) showed a migration of ≥3 mm. Cage migration was highest in the medio-medial position (84.6%), followed by the postero-lateral (42.9%), and the postero-medial (16%) cage position. Closed box cages had a significantly higher migration rate than open box cages, but fusion rates did not differ. In conclusion, cage positioning and cage type influence cage migration. The medio-medial cage position showed the highest migration rate. Regarding the cage type, open box cages seem to be associated with lower migration rates compared to closed box cages. However, the cage type did not influence bone fusion. PMID:19475436

  2. Applying hierarchical task analysis to improving the patient positioning for direct lateral interbody fusion in spinal surgery.

    PubMed

    Al-Hakim, Latif; Maiping, Tanaphon; Sevdalis, Nick

    2014-07-01

    The present study brings together for the first time the techniques of hierarchical task analysis (HTA), human error identification (HEI), and business process management (BPM) to select practices that can eliminate or reduce potential errors in a surgical setting. We applied the above approaches to the improvement of the patient positioning process for lumbar spine surgery referred to as 'direct lateral interbody fusion' (DLIF). Observations were conducted to gain knowledge on current DLIF positioning practices, and an HTA was constructed. Potential errors associated with the practices specific to DLIF patient positioning were identified. Based on literature review and expert views alternative practices are proposed aimed at improving the DLIF patient positioning process. To our knowledge, this is the first attempt to use BPM in association with HEI/HTA for the purpose of improving the performance and safety of a surgical process - with promising results.

  3. 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

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

    PubMed

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

    2016-01-01

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

  5. Minimally Invasive Transforaminal Lumbar Interbody Fusion with Unilateral Pedicle Screw Fixation: Comparison between Primary and Revision Surgery

    PubMed Central

    Kang, Moo Sung; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun

    2014-01-01

    Minimally invasive surgery with a transforaminal lumbar interbody fusion (MIS TLIF) is an important minimally invasive fusion technique for the lumbar spine. Lumbar spine reoperation is challenging and is thought to have greater complication risks. The purpose of this study was to compare MIS TLIF with unilateral screw fixation perioperative results between primary and revision surgeries. This was a prospective study that included 46 patients who underwent MIS TLIF with unilateral pedicle screw. The patients were divided into two groups, primary and revision MIS TLIF, to compare perioperative results and complications. The two groups were similar in age, sex, and level of operation, and were not significantly different in the length of follow-up or clinical results. Although dural tears were more common with the revision group (primary 1; revision 4), operation time, blood loss, total perioperative complication, and fusion rates were not significantly different between the two groups. Both groups showed substantial improvements in VAS and ODI scores one year after surgical treatment. Revision MIS TLIF performed by an experienced surgeon does not necessarily increase the risk of perioperative complication compared with primary surgery. MIS TLIF with unilateral pedicle screw fixation is a valuable option for revision lumbar surgery. PMID:24949483

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  8. Prevalence and Risk Factors of Deep Vein Thrombosis in Patients Undergoing Lumbar Interbody Fusion Surgery: A Single-Center Cross-Sectional Study.

    PubMed

    Yang, Si-Dong; Ding, Wen-Yuan; Yang, Da-Long; Shen, Yong; Zhang, Ying-Ze; Feng, Shi-Qing; Zhao, Feng-Dong

    2015-12-01

    This cross-sectional study was designed to obtain the current prevalence of deep vein thrombosis (DVT) and analyze related risk factors in patients undergoing lumbar interbody fusion. Medical record data were collected from Department of Spinal Surgery, The Third Hospital of Hebei Medical University, between July 2014 and March 2015. Both univariate analysis and binary logistic regression analysis were performed to determine risk factors for DVT. A total of 995 patients were admitted into this study, including 484 men and 511 women, aged from 14 to 89 years old (median 50, IQR 19). The detection rate of lower limb DVT by ultrasonography was 22.4% (223/995) in patients undergoing lumbar interbody fusion. Notably, average VAS (visual analog scale) score in the first 3 days after surgery in the DVT group was more than that in the non-DVT group (Z = -21.69, P < 0.001). The logistic regression model was established as logit P = -13.257 + 0.056*X1 - 0.243*X8 + 2.085*X10 + 0.001*X12, (X1 = age; X8 = HDL; X10 = VAS; X12 = blood transfusion; x = 677.763, P < 0.001). In conclusion, advanced age, high postoperative VAS scores, and blood transfusion were risk factors for postoperative lower limb DVT. As well, the logistic regression model may contribute to an early evaluation postoperatively to ascertain the risk of lower limb DVT in patients undergoing lumbar interbody fusion surgery.

  9. Good Functional Outcome and Adjacent Segment Disc Quality 10 Years after Single-Level Anterior Lumbar Interbody Fusion with Posterior Fixation

    PubMed Central

    Horsting, Philip P.; Pavlov, Paul W.; Jacobs, Wilco C.H.; Obradov-Rajic, Marina; de Kleuver, Marinus

    2012-01-01

    We reviewed the records of a prospective consecutive cohort to evaluate the clinical performance of anterior lumbar interbody fusion with a titanium box cage and posterior fixation, with emphasis on long-term functional outcome. Thirty-two patients with chronic low back pain underwent anterior lumbar interbody fusion and posterior fixation. Radiological and functional results (visual analogue scale [VAS] and Oswestry score) were evaluated. Adjacent segment degeneration (ASD) was evaluated radiologically and by magnetic resonance imaging (MRI). Twenty-five patients (78%) were available for follow-up. Functional scores showed significant improvement in pain and function up to the 2-year follow-up observation. At 4 years, there was some deterioration of the clinical results. At 10-year follow-up, results remained stable compared with 4-year results. MRI showed ASD in 3/25 (12%) above and 2/10 (20%) below index level (compared with absent preoperatively). ASD could not be related to clinical outcome in this study. Anterior lumbar interbody fusion and posterior fixation is safe and effective. Initial improvement in VAS and Oswestry scores is partly lost at the 4-year follow-up. Good clinical results are maintained at 10-year follow-up and are not related to adjacent segment degeneration. PMID:24353942

  10. The value of adding posterior interbody fusion in the surgical treatment of degenerative lumbar spine disorders: A systematic review

    PubMed Central

    Fallatah, Salah; Wai, Eugene; Baily, Christopher S.

    2013-01-01

    Background Posterolateral fusion (PF) is a common method by which to achieve fusion in lumbar spine surgery. It has been reported that posterior interbody fusion (PIF) yields a higher fusion rate and a better functional and clinical outcome. Our objective was to determine whether PIF improves the clinical and radiologic outcomes in adults surgically treated for degenerative lumbar spine conditions compared with PF. Methods We performed a systematic search of electronic databases, bibliographies, and relevant journals and meta-analyses. Results Of 2798 citations identified, 5 studies met our inclusion criteria (none of which was a randomized controlled trial), with a total of 148 patients in the PIF group (intervention) and 159 in the PF group (control). Pooled meta-analyses showed that nonunion rates were lower in the intervention group (relative risk, 0.22; 95% confidence interval [CI], 0.08–0.62). The intervention group had a significantly higher disc height (weighted mean difference, 3.2 mm; 95% CI, 1.9–4.4 mm) and lower residual percent slippage (weighted mean difference, 6.3%; 95% CI, 3.9%–8.7%) at final follow-up. There were no significant differences in segmental or total lumbar lordosis. Because of heterogeneity of results, no conclusions could be made with regard to functional benefits. Conclusions This review suggests that PIF achieves a higher fusion rate and better correction of certain radiographic aspects of deformity over PF. It also showed a slight but not significant trend toward a better functional outcome in the PIF group. The lack of randomized controlled trials and the methodologic limitations of the available studies call for the planning and conduct of a sufficiently sized, methodologically sound study with clinically relevant outcome measures. Until this has been done, the current evidence regarding the beneficial effects of PIF should be interpreted with caution. PMID:25694900

  11. Structural and mechanical evaluations of a topology optimized titanium interbody fusion cage fabricated by selective laser melting process.

    PubMed

    Lin, Chia-Ying; Wirtz, Tobias; LaMarca, Frank; Hollister, Scott J

    2007-11-01

    A topology optimized lumbar interbody fusion cage was made of Ti-Al6-V4 alloy by the rapid prototyping process of selective laser melting (SLM) to reproduce designed microstructure features. Radiographic characterizations and the mechanical properties were investigated to determine how the structural characteristics of the fabricated cage were reproduced from design characteristics using micro-computed tomography scanning. The mechanical modulus of the designed cage was also measured to compare with tantalum, a widely used porous metal. The designed microstructures can be clearly seen in the micrographs of the micro-CT and scanning electron microscopy examinations, showing the SLM process can reproduce intricate microscopic features from the original designs. No imaging artifacts from micro-CT were found. The average compressive modulus of the tested caged was 2.97+/-0.90 GPa, which is comparable with the reported porous tantalum modulus of 3 GPa and falls between that of cortical bone (15 GPa) and trabecular bone (0.1-0.5 GPa). The new porous Ti-6Al-4V optimal-structure cage fabricated by SLM process gave consistent mechanical properties without artifactual distortion in the imaging modalities and thus it can be a promising alternative as a porous implant for spine fusion.

  12. The Negligible Influence of Chronic Obesity on Hospitalization, Clinical Status, and Complications in Elective Posterior Lumbar Interbody Fusion

    PubMed Central

    Kombos, Theodoros; Bode, Frank

    2016-01-01

    Background. Posterior lumbar interbody fusion (PLIF) is a common surgical treatment for degenerative spinal instability, but many surgeons consider obesity a contraindication for elective spinal fusion. The aim of this study was to analyze whether obesity has any influence on hospitalization parameters, change in clinical status, or complications. Methods. In this prospective study, regression analysis was used to analyze the influence of the body mass index (BMI) on operating time, postoperative care, hospitalization time, type of postdischarge care, change in paresis or sensory deficits, pain level, wound complications, cerebrospinal fluid leakage, and implant complications. Results. Operating time increased only 2.5 minutes for each increase of BMI by 1. The probability of having a wound complication increased statistically with rising BMI. Nonetheless, BMI accounted for very little of the variation in the data, meaning that other factors or random chances play a much larger role. Conclusions. Obesity has to be considered a risk factor for wound complications in patients undergoing elective PLIF for degenerative instability. However, BMI showed no significant influence on other kinds of peri- or postoperative complications, nor clinical outcomes. So obesity cannot be considered a contraindication for elective PLIF. PMID:27478866

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

    PubMed Central

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

    2016-01-01

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

  14. Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

    PubMed Central

    Kim, Woong-Beom; Choi, Hoyong; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2016-01-01

    Objective The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2–7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating. PMID:27446521

  15. Minimally Invasive Multi-Level Posterior Lumbar Interbody Fusion Using a Percutaneously Inserted Spinal Fixation System : Technical Tips, Surgical Outcomes

    PubMed Central

    Kim, Hyeun Sung; Park, Keun Ho; Ju, Chag Il; Lee, Seung Myung; Shin, Ho

    2011-01-01

    Objective There are technical limitations of multi-level posterior pedicle screw fixation performed by the percutaneous technique. The purpose of this study was to describe the surgical technique and outcome of minimally invasive multi-level posterior lumbar interbody fusion (PLIF) and to determine its efficacy. Methods Forty-two patients who underwent mini-open PLIF using the percutaneous screw fixation system were studied. The mean age of the patients was 59.1 (range, 23 to 78 years). Two levels were involved in 32 cases and three levels in 10 cases. The clinical outcome was assessed using the visual analog scale (VAS) and Low Back Outcome Score (LBOS). Achievement of radiological fusion, intra-operative blood loss, the midline surgical scar and procedure related complications were also analyzed. Results The mean follow-up period was 25.3 months. The mean LBOS prior to surgery was 34.5, which was improved to 49.1 at the final follow up. The mean pain score (VAS) prior to surgery was 7.5 and it was decreased to 2.9 at the last follow up. The mean estimated blood loss was 238 mL (140-350) for the two level procedures and 387 mL (278-458) for three levels. The midline surgical scar was 6.27 cm for two levels and 8.25 cm for three level procedures. Complications included two cases of asymptomatic medial penetration of the pedicle border. However, there were no signs of neurological deterioration or fusion failure. Conclusion Multi-level, minimally invasive PLIF can be performed effectively using the percutaneous transpedicular screw fixation system. It can be an alternative to the traditional open procedures. PMID:22259691

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

    PubMed Central

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

    2009-01-01

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

  17. Evaluation of an injectable silk fibroin enhanced calcium phosphate cement loaded with human recombinant bone morphogenetic protein-2 in ovine lumbar interbody fusion.

    PubMed

    Gu, Yong; Chen, Liang; Yang, Hui-Lin; Luo, Zong-Ping; Tang, Tian-Si

    2011-05-01

    The objective of this study was to investigate the efficacy of an injectable calcium phosphate cement/silk fibroin/human recombinant bone morphogenetic protein-2 composite (CPC/SF/rhBMP-2) in an ovine interbody fusion model. Twenty-four mature sheep underwent anterior lumbar interbody fusion at the levels of L1/2, L3/4, and L5/6 with random implantation of CPC/SF, CPC/rhBMP-2, CPC/SF/rhBMP-2, or autogenous iliac bone. After the sheep were sacrificed, the fusion segments were evaluated by manual palpation, CT scan, undestructive biomechanical testing, undecalcified histology, and histomorphology. The fusion rates of CPC/SF/rhBMP-2 were 55.56% and 77.78% at 6 and 12 months, respectively. The fusion was superior to all the biomaterial grafts in stiffness, and reached the same stiffness as the autograft at 12 months. The new bone formation was less than autograft at 6 months, but similar with that at 12 months. However, the ceramic residue volume of CPC/SF/rhBMP-2 was significantly decreased compared with CPC/SF and CPC/rhBMP-2 at both times. The results indicated that CPC/SF/rhBMP-2 composite had excellent osteoconduction and osteoinduction, and balanced degradation and osteogenesis.

  18. Remodeling of heat-treated cortical bone allografts for posterior lumbar interbody fusion: serial 10-year follow-up.

    PubMed

    Muramatsu, Koichi; Hachiya, Yudo; Izawa, Hiroyuki; Yamada, Harumoto

    2012-12-01

    We have selected heat-treated bone allografts as the graft material since the Tokai Bone Bank, the first regional bone bank in Japan, was established in 1992. In this study, we examined changes in bone mineral density (BMD), and morphology observed by magnetic resonance imaging (MRI), and histological findings of bone grafts in cases followed up for 7-10 years after bone grafting to grasp the remodeling of heat-treated cortical bone allografts for posterior lumber interbody fusion (PLIF). BMD of bone grafts was reduced by half at 10 years after grafting. MRI revealed that bone grafts were indistinguishable initially in only 22.2% of cases, whereas after a lengthy period of 10 years distinguishable in many cases. Histologically, new bone formation at the graft-host interface was observed earlier, at 1 year after grafting, than that at the periphery of canals in the specimens. The laminated structure of the cortical bone eroded over time, and fragmented bone trabeculae were observed in the specimens at 8 years or longer after grafting, though necrotic bone still remained in some sites.

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

    PubMed

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

    2016-03-01

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

  20. Neurological Complications after Lateral Transpsoas Approach to Anterior Interbody Fusion with a Novel Flat-Blade Spine-Fixed Retractor

    PubMed Central

    Nunley, Pierce; Sandhu, Faheem; Frank, Kelly; Stone, Marcus

    2016-01-01

    Introduction. The lateral lumbar interbody fusion (LLIF) surgical approach has potential advantages over other approaches but is associated with some unique neurologic risks due to the proximity of the lumbosacral plexus. The present study analyzed complications following LLIF surgical approach using a novel single flat-blade retractor system. Methods. A retrospective data collection of patients receiving LLIF using a novel single flat-blade retractor system at two institutions in the US. Inclusion criteria were all patients receiving an LLIF procedure with the RAVINE® Lateral Access System (K2M, Inc., Leesburg, VA, USA). There was no restriction on preoperative diagnosis or number of levels treated. Approach-related neurologic complications were collected and analyzed postoperatively through a minimum of one year. Results. Analysis included 253 patients with one to four treated lateral levels. Immediate postoperative neurologic complications were present in 11.1% (28/253) of patients. At one-year follow-up the approach-related neurologic complications resolved in all except 5 patients (2.0%). Conclusion. We observed an 11.1% neurologic complication rate in LLIF procedures. There was resolution of symptoms for most patients by 12-month follow-up, with only 2% of patients with residual symptoms. This supports the hypothesis that the vast majority of approach-related neurologic symptoms are transient. PMID:27294140

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

    PubMed Central

    Choovongkomol, Kongtush; Piyapromdee, Urawit; Leownorasate, Manoon

    2016-01-01

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

  2. Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

    PubMed Central

    Jo, Dae-Jean; Jun, Jae-Kyun; Kim, Ki-Tack

    2010-01-01

    Objective To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (36.1%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A, perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in

  3. Late Results of Anterior Cervical Discectomy and Fusion with Interbody Cages

    PubMed Central

    Dağlı, Murat; Şimşek, Serkan; Bavbek, Murad

    2013-01-01

    Study Design Retrospective analysis. Purpose To evaluate the effectiveness of anterior cervical discectomy with fusion for degenerative cervical disc disease. Overview of Literature Anterior spinal surgery originated in the mid-1950s and graft for fusion was also employed. Currently anterior cervical microdiscectomy and fusion with an intervertebral cage is a widely accepted procedure for treatment of cervical disc hernia. Artificial grafts and cages for fusion are preferred because of their lower morbidity, reduced operating time and acceptable fusion rate. Methods The study involved retrospective analysis and investigation of long-term results for 41 consecutive patients who had undergone anterior cervical discectomy and fusion with an intervertebral cage for cervical disc hernia. The angle of lordosis, segmental height and range of motion were evaluated preoperatively and postoperatively at 1 month and 2 years. The clinical outcome was assessed by the visual analog scale and Odom's criteria. Results The angle of lordosis increased by 2.62° and the range of motion angle increased by 5.14° after the operation. The segmental height did not change. The visual analog scale and Odom's criteria scores decreased significantly after the operation. Conclusions Using a cage in anterior cervical discectomy prevents segmental collapse, so the segmental height and the angle of lordosis are preserved and newly-developed pain does not occur. PMID:23508467

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

    PubMed Central

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

    2014-01-01

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

  5. Fixation Strength of Caudal Pedicle Screws after Posterior Lumbar Interbody Fusion with the Modified Cortical Bone Trajectory Screw Method

    PubMed Central

    Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

    2016-01-01

    Study Design Clinical case series. Purpose In the posterior lumbar interbody fusion (PLIF) procedure in our institute, the cephalad screw trajectory follows a mediolateral and caudocephalad directed path according to the original cortical bone trajectory (CBT) method. However, the starting point of the caudal screw is at the medial border of the pedicle on an articular surface of the superior articular process, and the trajectory takes a mediolateral path parallel to the cephalad endplate. The incidence of caudal screw loosening after PLIF with this modified CBT screw method was investigated, and significant risk factors for caudal screw loosening were evaluated. Overview of Literature A biomechanical study of this modified caudal screw trajectory using the finite element method reported about a 20% increase in uniaxial yield pullout load compared with the traditional trajectory. However, there has been no clinical study concerning the fixation strength of this modified caudal screw trajectory. Methods The subjects were 193 consecutive patients who underwent single-level PLIF with modified CBT screw fixation. Caudal screw loosening was checked in computed tomography at 6 months after surgery, and screw loosening was defined as a radiolucency of 1 mm or more at the bone-screw interface. Results The incidence of caudal screw loosening after lumbosacral PLIF (46.2%) was significantly higher than that after floating PLIF (6.0%). No significant differences in sex, brand of the instruments, and diameter and length of the caudal screw were evident between patients with and without caudal screw loosening. Patients with caudal screw loosening were significantly older at the time of surgery than patients without caudal screw loosening. Conclusions Fixation strength of the caudal screw after floating PLIF with this modified CBT screw technique was sufficiently acceptable. Fixation strength after the lumbosacral procedure was not. PMID:27559442

  6. Comparative Study between a Curved and a Wedge PEEK Cage for Single-level Anterior Cervical Discectomy and Interbody Fusion

    PubMed Central

    Kim, Hwan Soo; Heo, Weon; Cha, Jae Hoon; Rhee, Dong Youl

    2012-01-01

    Objective This study evaluated the efficiency of a curved polyetheretherketone (PEEK) cage in comparison with a wedge PEEK cage according to radiologic and clinical outcomes in patients with cervical degenerative disease. Methods A total of 37 patients who suffering from cervical disc disease with radiculopathy or myelopathy were reviewed retrospectively. Seventeen patients were underwent anterior cervical discectomy and interbody fusion with a curved shape PEEK cage (curved cage group), and twenty patients with wedge shape PEEK cage (wedge cage group). Clinical assessment was graded using Odom's criteria, NDI score and VAS score. For radiologic analysis, disc height (DH), segmental angle (SA), subsidence were measured at the preoperative and last follow up. Results A comparison of the preoperative and postoperative results revealed improvements after the surgery in the DH and SA in both cage groups. The change of postoperative DH between the preoperative and the last follow-up in wedge cage group and curved cage group was 6.85% and 25.5%, respectively. The change of postoperative SA was 1.75° and 0.95°, respectively. There was no statistically significant difference in the DH and SA between the 2 groups. The subsidence rate in the wedge cage group and curved cage group was 20% and 6%, respectively. Conclusion The 2 different cage groups showed significant improvements in the disc height, segmental angle and clinical outcomes. However, the shape of PEEK Cage influences the tendency for subsidence. Increasing contact surface area and fitting into two adjacent vertebral body prevent significant subsidence. PMID:25983812

  7. Comparison of Clinical and Radiological Results of Posterolateral Fusion and Posterior Lumbar Interbody Fusion in the Treatment of L4 Degenerative Lumbar Spondylolisthesis

    PubMed Central

    Kuraishi, Shugo; Mukaiyama, Keijiro; Shimizu, Masayuki; Ikegami, Shota; Futatsugi, Toshimasa; Hirabayashi, Hiroki; Ogihara, Nobuhide; Hashidate, Hiroyuki; Tateiwa, Yutaka; Kinoshita, Hisatoshi; Kato, Hiroyuki

    2016-01-01

    Study Design Multicenter analysis of two groups of patients surgically treated for degenerative L4 unstable spondylolisthesis. Purpose To compare the clinical and radiographic outcomes of posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) for degenerative L4 unstable spondylolisthesis. Overview of Literature Surgery for lumbar degenerative spondylolisthesis is widely performed. However, few reports have compared the outcome of PLF to that of PLIF for degenerative L4 unstable spondylolisthesis. Methods Patients with L4 unstable spondylolisthesis with Meyerding grade II or more, slip of >10° or >4 mm upon maximum flexion and extension bending, and posterior opening of >5 degree upon flexion bending were studied. Patients were treated from January 2008 to January 2010. Patients who underwent PLF (n=12) and PLIF (n=19) were followed-up for >2 years. Radiographic findings and clinical outcomes evaluated by the Japanese Orthopaedic Association (JOA) score were compared between the two groups. Radiographic evaluation included slip angle, translation, slip angle and translation during maximum flexion and extension bending, intervertebral disc height, lumbar lordotic angle, and fusion rate. Results JOA scores of the PLF group before surgery and at final follow-up were 12.3±4.8 and 24.1±3.7, respectively; those of the PLIF group were 14.7±4.8 and 24.2±7.8, respectively, with no significant difference between the two groups. Correction of slip estimated from postoperative slip angle, translation, and maintenance of intervertebral disc height in the PLIF group was significantly (p<0.05) better than those in the PLF group. However, there was no significant difference in lumbar lordotic angle, slip angle and translation angle upon maximum flexion, or extension bending. Fusion rates of the PLIF and PLF groups had no significant difference. Conclusions The L4–L5 level posterior instrumented fusion for unstable spondylolisthesis using both PLF and PLIF

  8. Subsidence and Nonunion after Anterior Cervical Interbody Fusion Using a Stand-Alone Polyetheretherketone (PEEK) Cage

    PubMed Central

    Yang, Jae Jun; Yu, Chang Hun; Yeom, Jin Sup; Lee, Jae Hyup; Lee, Choon-Ki

    2011-01-01

    Background The purposes of the present study are to evaluate the subsidence and nonunion that occurred after anterior cervical discectomy and fusion using a stand-alone intervertebral cage and to analyze the risk factors for the complications. Methods Thirty-eight patients (47 segments) who underwent anterior cervical fusion using a stand-alone polyetheretherketone (PEEK) cage and an autologous cancellous iliac bone graft from June 2003 to August 2008 were enrolled in this study. The anterior and posterior segmental heights and the distance from the anterior edge of the upper vertebra to the anterior margin of the cage were measured on the plain radiographs. Subsidence was defined as ≥ a 2 mm (minor) or 3 mm (major) decrease of the segmental height at the final follow-up compared to that measured at the immediate postoperative period. Nonunion was evaluated according to the instability being ≥ 2 mm in the interspinous distance on the flexion-extension lateral radiographs. Results The anterior and posterior segmental heights decreased from the immediate postoperative period to the final follow-up at 1.33 ± 1.46 mm and 0.81 ± 1.27 mm, respectively. Subsidence ≥ 2 mm and 3 mm were observed in 12 segments (25.5%) and 7 segments (14.9%), respectively. Among the expected risk factors for subsidence, a smaller anteroposterior (AP) diameter (14 mm vs. 12 mm) of cages (p = 0.034; odds ratio [OR], 0.017) and larger intraoperative distraction (p = 0.041; OR, 3.988) had a significantly higher risk of subsidence. Intervertebral nonunion was observed in 7 segments (7/47, 14.9%). Compared with the union group, the nonunion group had a significantly higher ratio of two-level fusion to one-level fusions (p = 0.001). Conclusions Anterior cervical fusion using a stand-alone cage with a large AP diameter while preventing anterior intraoperative over-distraction will be helpful to prevent the subsidence of cages. Two-level cervical fusion might require more careful attention

  9. Retroperitoneal hematoma after using the extreme lateral interbody fusion (XLIF) approach: Presentation of a case and a review of the literature.

    PubMed

    Peiró-García, A; Domínguez-Esteban, I; Alía-Benítez, J

    2016-01-01

    The transpsoas approach, also known as extreme lateral interbody fusion (XLIF), to the lumbar spine is a novel minimally invasive technique with positive clinical outcomes and a low complication rate. There is a low risk of bleeding, due to this approach causing less soft tissue disruption than traditional spine surgery, but segmental arteries and great vessels can be damaged. Retroperitoneal haematoma is a major complication, with few cases reported. This is the first case reported in a Stand-alone XLIF and also the first case reported with haemorrhagic shock. Non-specific symptoms such tachycardia, hypotension, and anaemia are the most prevalent in this complication. With this case, our aim is to describe serious complications related to XLIF. PMID:25703640

  10. Retroperitoneal hematoma after using the extreme lateral interbody fusion (XLIF) approach: Presentation of a case and a review of the literature.

    PubMed

    Peiró-García, A; Domínguez-Esteban, I; Alía-Benítez, J

    2016-01-01

    The transpsoas approach, also known as extreme lateral interbody fusion (XLIF), to the lumbar spine is a novel minimally invasive technique with positive clinical outcomes and a low complication rate. There is a low risk of bleeding, due to this approach causing less soft tissue disruption than traditional spine surgery, but segmental arteries and great vessels can be damaged. Retroperitoneal haematoma is a major complication, with few cases reported. This is the first case reported in a Stand-alone XLIF and also the first case reported with haemorrhagic shock. Non-specific symptoms such tachycardia, hypotension, and anaemia are the most prevalent in this complication. With this case, our aim is to describe serious complications related to XLIF.

  11. Clinical outcomes of lumbar degenerative disc disease treated with posterior lumbar interbody fusion allograft spacer: a prospective, multicenter trial with 2-year follow-up.

    PubMed

    Arnold, Paul M; Robbins, Stephen; Paullus, Wayne; Faust, Stephen; Holt, Richard; McGuire, Robert

    2009-07-01

    The clinical benefits and complications of posterior lumbar interbody fusion (PLIF) have been studied over the past 60 years. In recent years, spine surgeons have had the option of treating low back pain caused by degenerative disc disease using PLIF with machined allograft spacers and posterior pedicle fixation. The purpose of this clinical series was to assess the clinical benefits of using a machined PLIF allograft spacer and posterior pedicle fixation to treat degenerative disc disease, both in terms of fusion rates and patient outcomes, and to compare these results with those in previous studies using autograft and metal interbody fusion devices. Results were also compared with results from studies using transverse process fusion. This prospective, nonrandomized clinical series was conducted at 10 US medical centers. Eighty-nine (55 male, 34 female) patients underwent PLIF with a presized, machined allograft spacer and posterior pedicle fixation between January 2000 and April 2003. Their outcomes were compared with outcomes in previous series described in the literature. All patients had experienced at least 6 months of low back pain that had been unresponsive to nonsurgical treatment. Physical examinations were performed before surgery, after surgery, and at 4 follow-up visits (6 weeks, 6 months, 12 months, 24 months). At each interval, we obtained radiographs and patient outcome measures, including SF-36 Bodily Pain Score, visual analog scale pain rating, and Oswestry Disability Index. The primary outcome was fusion results at 12 and 24 months; the secondary outcomes were pain, disability, function/quality of life, and satisfaction. One-level PLIFs were performed in 65 patients, and 2-level PLIFs in 24 patients. Flexion-extension radiographs at 12 and 24 months revealed a 98% fusion rate. Of the 72 patients who reached the 12-month follow-up, 86% reported decreased pain and disability as measured with the Oswestry Disability Index. Decreased pain as measured

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

    PubMed Central

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

    2015-01-01

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

  13. Hospital charges associated with "never events": comparison of anterior cervical discectomy and fusion, posterior lumbar interbody fusion, and lumbar laminectomy to total joint arthroplasty.

    PubMed

    Daniels, Alan H; Kawaguchi, Satoshi; Contag, Alec G; Rastegar, Farbod; Waagmeester, Garrett; Anderson, Paul A; Arthur, Melanie; Hart, Robert A

    2016-08-01

    OBJECTIVE Beginning in 2008, the Centers for Medicare and Medicaid Service (CMS) determined that certain hospital-acquired adverse events such as surgical site infection (SSI) following spine surgery should never occur. The following year, they expanded the ruling to include deep vein thrombosis (DVT) and pulmonary embolism (PE) following total joint arthroplasty. Due to their ruling that "never events" are not the payers' responsibility, CMS insists that the costs of managing these complications be borne by hospitals and health care providers, rather than billings to health care payers for additional care required in their management. Data comparing the expected costs of such adverse events in patients undergoing spine and orthopedic surgery have not previously been reported. METHODS The California State Inpatient Database (CA-SID) from 2008 to 2009 was used for the analysis. All patients with primary procedure codes indicating anterior cervical discectomy and fusion (ACDF), posterior lumbar interbody fusion (PLIF), lumbar laminectomy (LL), total knee replacement (TKR), and total hip replacement (THR) were analyzed. Patients with diagnostic and/or treatment codes for DVT, PE, and SSI were separated from patients without these complication codes. Patients with more than 1 primary procedure code or more than 1 complication code were excluded. Median charges for treatment from primary surgery through 3 months postoperatively were calculated. RESULTS The incidence of the examined adverse events was lowest for ACDF (0.6% DVT, 0.1% PE, and 0.03% SSI) and highest for TKA (1.3% DVT, 0.3% PE, 0.6% SSI). Median inpatient charges for uncomplicated LL was $51,817, compared with $73,432 for ACDF, $143,601 for PLIF, $74,459 for THR, and $70,116 for TKR. Charges for patients with DVT ranged from $108,387 for TKR (1.5 times greater than index) to $313,536 for ACDF (4.3 times greater than index). Charges for patients with PE ranged from $127,958 for TKR (1.8 times greater than

  14. Surgical Data and Early Postoperative Outcomes after Minimally Invasive Lumbar Interbody Fusion: Results of a Prospective, Multicenter, Observational Data-Monitored Study

    PubMed Central

    Pereira, Paulo; Buzek, David; Franke, Jörg; Senker, Wolfgang; Kosmala, Arkadiusz; Hubbe, Ulrich; Manson, Neil; Rosenberg, Wout; Assietti, Roberto; Martens, Frederic; Barbanti Brodano, Giovanni; Scheufler, Kai-Michael

    2015-01-01

    Minimally invasive lumbar interbody fusion (MILIF) offers potential for reduced operative morbidity and earlier recovery compared with open procedures for patients with degenerative lumbar disorders (DLD). Firm conclusions about advantages of MILIF over open procedures cannot be made because of limited number of large studies of MILIF in a real-world setting. Clinical effectiveness of MILIF in a large, unselected real-world patient population was assessed in this Prospective, monitored, international, multicenter, observational study. Objective: To observe and document short-term recovery after minimally invasive interbody fusion for DLD. Materials and Methods: In a predefined 4-week analysis from this study, experienced surgeons (≥30 MILIF surgeries pre-study) treated patients with DLD by one- or two-level MILIF. The primary study objective was to document patients’ short-term post-interventional recovery (primary objective) including back/leg pain (visual analog scale [VAS]), disability (Oswestry Disability Index [ODI]), health status (EQ-5D) and Patient satisfaction. Results: At 4 weeks, 249 of 252 patients were remaining in the study; the majority received one-level MILIF (83%) and TLIF was the preferred approach (94.8%). For one-level (and two-level) procedures, surgery duration was 128 (182) min, fluoroscopy time 115 (154) sec, and blood-loss 164 (233) mL. Time to first ambulation was 1.3 days and time to study-defined surgery recovery was 3.2 days. Patients reported significantly (P < 0.0001) reduced back pain (VAS: 2.9 vs 6.2), leg pain (VAS: 2.5 vs 5.9), and disability (ODI: 34.5% vs 45.5%), and a significantly (P < 0.0001) improved health status (EQ-5D index: 0.61 vs 0.34; EQ VAS: 65.4 vs 52.9) 4 weeks postoperatively. One adverse event was classified as related to the minimally invasive surgical approach. No deep site infections or deaths were reported. Conclusions: For experienced surgeons, MILIF for DLD demonstrated early benefits (short time to

  15. Biological performance of a polycaprolactone-based scaffold used as fusion cage device in a large animal model of spinal reconstructive surgery.

    PubMed

    Abbah, Sunny A; Lam, Christopher X L; Hutmacher, Dietmar W; Goh, James C H; Wong, Hee-Kit

    2009-10-01

    A bioactive and bioresorbable scaffold fabricated from medical grade poly (epsilon-caprolactone) and incorporating 20% beta-tricalcium phosphate (mPCL-TCP) was recently developed for bone regeneration at load bearing sites. In the present study, we aimed to evaluate bone ingrowth into mPCL-TCP in a large animal model of lumbar interbody fusion. Six pigs underwent a 2-level (L3/4; L5/6) anterior lumbar interbody fusion (ALIF) implanted with mPCL-TCP + 0.6 mg rhBMP-2 as treatment group while four other pigs implanted with autogenous bone graft served as control. Computed tomographic scanning and histology revealed complete defect bridging in all (100%) specimen from the treatment group as early as 3 months. Histological evidence of continuing bone remodeling and maturation was observed at 6 months. In the control group, only partial bridging was observed at 3 months and only 50% of segments in this group showed complete defect bridging at 6 months. Furthermore, 25% of segments in the control group showed evidence of graft fracture, resorption and pseudoarthrosis. In contrast, no evidence of graft fractures, pseudoarthrosis or foreign body reaction was observed in the treatment group. These results reveal that mPCL-TCP scaffolds could act as bone graft substitutes by providing a suitable environment for bone regeneration in a dynamic load bearing setting such as in a porcine model of interbody spine fusion. PMID:19540586

  16. Comparison Between Posterior Short-segment Instrumentation Combined With Lateral-approach Interbody Fusion and Traditional Wide-open Anterior-Posterior Surgery for the Treatment of Thoracolumbar Fractures

    PubMed Central

    Li, Xiang; Zhang, Junwei; Tang, Hehu; Lu, Zhen; Liu, Shujia; Chen, Shizheng; Hong, Yi

    2015-01-01

    Abstract The aim of the study was to compare the radiographic and clinical outcomes between posterior short-segment pedicle instrumentation combined with lateral-approach interbody fusion and traditional anterior-posterior (AP) surgery for the treatment of thoracolumbar fractures. Lateral-approach interbody fusion has achieved satisfactory results for thoracic and lumbar degenerative disease. However, few studies have focused on the use of this technique for the treatment of thoracolumbar fractures. Inclusion and exclusion criteria were established. All patients who meet the above criteria were prospectively treated by posterior short-segment instrumentation and secondary-staged minimally invasive lateral-approach interbody fusion, and classified as group A. A historical group of patients who were treated by traditional wide-open AP approach was used as a control group and classified as group B. The radiological and clinical outcomes were compared between the 2 groups. There were 12 patients in group A and 18 patients in group B. The mean operative time and intraoperative blood loss of anterior reconstruction were significantly higher in group B than those in group A (127.1 ± 21.7 vs 197.5 ± 47.7 min, P < 0.01; 185.8 ± 62.3 vs 495 ± 347.4 mL, P < 0.01). Two of the 12 (16.7%) patients in group A experienced 2 surgical complications: 1 (8.3%) major and 1 (8.3%) minor. Six of the 18 (33%) patients in group B experienced 9 surgical complications: 3 (16.7%) major and 6 (33.3%) minor. There was no significant difference between the 2 groups regarding loss of correction (4.3 ± 2.1 vs 4.2 ± 2.4, P = 0.89) and neurological function at final follow-up (P = 0.77). In both groups, no case of instrumentation failure, pseudarthrosis, or nonunion was noted. Compared with the wide-open AP surgery, posterior short-segment pedicle instrumentation, combined with minimally invasive lateral-approach interbody fusion, can achieve similar

  17. Dynamic stabilization for L4-5 spondylolisthesis: comparison with minimally invasive transforaminal lumbar interbody fusion with more than 2 years of follow-up.

    PubMed

    Kuo, Chao-Hung; Chang, Peng-Yuan; Wu, Jau-Ching; Chang, Hsuan-Kan; Fay, Li-Yu; Tu, Tsung-Hsi; Cheng, Henrich; Huang, Wen-Cheng

    2016-01-01

    OBJECTIVE In the past decade, dynamic stabilization has been an emerging option of surgical treatment for lumbar spondylosis. However, the application of this dynamic construct for mild spondylolisthesis and its clinical outcomes remain uncertain. This study aimed to compare the outcomes of Dynesys dynamic stabilization (DDS) with minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the management of single-level spondylolisthesis at L4-5. METHODS This study retrospectively reviewed 91 consecutive patients with Meyerding Grade I spondylolisthesis at L4-5 who were managed with surgery. Patients were divided into 2 groups: DDS and MI-TLIF. The DDS group was composed of patients who underwent standard laminectomy and the DDS system. The MI-TLIF group was composed of patients who underwent MI-TLIF. Clinical outcomes were evaluated by visual analog scale for back and leg pain, Oswestry Disability Index, and Japanese Orthopaedic Association scores at each time point of evaluation. Evaluations included radiographs and CT scans for every patient for 2 years after surgery. RESULTS A total of 86 patients with L4-5 spondylolisthesis completed the follow-up of more than 2 years and were included in the analysis (follow-up rate of 94.5%). There were 64 patients in the DDS group and 22 patients in the MI-TLIF group, and the overall mean follow-up was 32.7 months. Between the 2 groups, there were no differences in demographic data (e.g., age, sex, and body mass index) or preoperative clinical evaluations (e.g., visual analog scale back and leg pain, Oswestry Disability Index, and Japanese Orthopaedic Association scores). The mean estimated blood loss of the MI-TLIF group was lower, whereas the operation time was longer compared with the DDS group (both p < 0.001). For both groups, clinical outcomes were significantly improved at 6, 12, 18, and 24 months after surgery compared with preoperative clinical status. Moreover, there were no differences between the 2

  18. The CASCADE trial: effectiveness of ceramic versus PEEK cages for anterior cervical discectomy with interbody fusion; protocol of a blinded randomized controlled trial

    PubMed Central

    2013-01-01

    Background Anterior cervical discectomy with interbody fusion cages is considered the standard surgical procedure in patients with cervical disc herniation. However, PEEK or metal cages have some undesirable imaging characteristics, leading to a search for alternative materials not creating artifacts on images; silicon nitride ceramic. Whether patients treated with silicon nitride ceramic cages have similar functional outcome as patients treated with PEEK cages is not known. We present the design of the CASCADE trial on effectiveness of ceramic cages versus PEEK cages in patients with cervical disc herniation and/or osteophytes. Methods/Design Patients (age 18–75 years) with monoradicular symptoms in one or both arms lasting more than 8 weeks, due to disc herniation and/or osteophytes, are eligible for the trial. The study is designed as a randomized controlled equivalence trial in which patients are blinded to the type of cage for 1 year. The total follow-up period is 2 years. The primary outcome measure is improvement in the Neck and Disability Index (NDI). Secondary outcomes measures include improvement in arm pain and neck pain (VAS), SF-36 and patients' perceived recovery. The final elements of comparison are perioperative statistics including operating time, blood loss, length of hospital stay, and adverse events. Lateral plane films at each follow-up visit and CT scan (at 6 months) will be used to judge fusion and the incidence of subsidence. Based on a power of 90% and assuming 8% loss to follow-up, 100 patients will be randomized into the 2 groups. The first analysis will be conducted when all patients have 1 year of follow-up, and the groups will be followed for 1 additional year to judge stability of outcomes. Discussion While the new ceramic cage has received the CE Mark based on standard compliance and animal studies, a randomized comparative study with the golden standard product will provide more conclusive information for clinicians

  19. Theater and ALife Art: Modeling Open and Closed Systems.

    PubMed

    Norman, Sally Jane

    2015-01-01

    The live art of theater remains curiously missing from ALife art history, despite the fact that its very existence is poised on the cusp of the living and the artificial, and on the modeling of life as artefact-what can be called the containment-versus-continuity dilemma. How far one seeks to affirm autonomy of the creative artwork or, in contrast, how far one seeks to affirm its continuity with its supposed real-life contexts is a question that has forever haunted theater, and that has naturally come to haunt ALife and ALife arts. Investigation of the boundary separating observers from modeled systems is as core to research into the live art of theater as to ALife research. This brief article seeks to open up discussion on links between ALife, ALife art, and the live art of theater, through key thematic threads that traverse these domains: their modeling of universes, the open or closed nature of the resultant modeled systems, and their implications with respect to observers, definitions, and instantiations of life regarding non-life or death as well as attributions of liveness to emergent synthetic biology and metamaterials. PMID:26280075

  20. Advances in Spinal Interbody Cages.

    PubMed

    Jain, Sukrit; Eltorai, Adam E M; Ruttiman, Roy; Daniels, Alan H

    2016-08-01

    Since the late 1980s, spinal interbody cages (ICs) have been used to aid bone fusion in a variety of spinal disorders. Utilized to restore intervertebral height, enable bone graft containment for arthrodesis, and restore anterior column biomechanical stability, ICs have since evolved to become a highly successful means of achieving fusion, being associated with less postoperative pain, shorter hospital stay, fewer complications and higher rates of fusion when than bone graft only spinal fusion. IC design and materials have changed considerably over the past two decades. The threaded titanium-alloy cylindrical screw cages, typically filled with autologous bone graft, of the mid-1990s achieved greater fusion rates than bone grafts and non-threaded cages. Threaded screw cages, however, were soon found to be less stable in extension and flexion; additionally, they had a high incidence of cage subsidence. As of the early 2000s, non-threaded box-shaped titanium or polyether ether ketone IC designs have become increasingly more common. This modern design continues to achieve greater cage stability in flexion, axial rotation and bending. However, cage stability and subsidence, bone fusion rates and surgical complications still require optimization. Thus, this review provides an update of recent research findings relevant to ICs over the past 3 years, highlighting trends in optimization of cage design, materials, alternatives to bone grafts, and coatings that may enhance fusion. PMID:27627709

  1. Static and dynamic fatigue behavior of topology designed and conventional 3D printed bioresorbable PCL cervical interbody fusion devices.

    PubMed

    Knutsen, Ashleen R; Borkowski, Sean L; Ebramzadeh, Edward; Flanagan, Colleen L; Hollister, Scott J; Sangiorgio, Sophia N

    2015-09-01

    Recently, as an alternative to metal spinal fusion cages, 3D printed bioresorbable materials have been explored; however, the static and fatigue properties of these novel cages are not well known. Unfortunately, current ASTM testing standards used to determine these properties were designed prior to the advent of bioresorbable materials for cages. Therefore, the applicability of these standards for bioresorbable materials is unknown. In this study, an image-based topology and a conventional 3D printed bioresorbable poly(ε)-caprolactone (PCL) cervical cage design were tested in compression, compression-shear, and torsion, to establish their static and fatigue properties. Difficulties were in fact identified in establishing failure criteria and in particular determining compressive failure load. Given these limitations, under static loads, both designs withstood loads of over 650 N in compression, 395 N in compression-shear, and 0.25 Nm in torsion, prior to yielding. Under dynamic testing, both designs withstood 5 million (5M) cycles of compression at 125% of their respective yield forces. Geometry significantly affected both the static and fatigue properties of the cages. The measured compressive yield loads fall within the reported physiological ranges; consequently, these PCL bioresorbable cages would likely require supplemental fixation. Most importantly, supplemental testing methods may be necessary beyond the current ASTM standards, to provide more accurate and reliable results, ultimately improving preclinical evaluation of these devices. PMID:26072198

  2. Static and dynamic fatigue behavior of topology designed and conventional 3D printed bioresorbable PCL cervical interbody fusion devices.

    PubMed

    Knutsen, Ashleen R; Borkowski, Sean L; Ebramzadeh, Edward; Flanagan, Colleen L; Hollister, Scott J; Sangiorgio, Sophia N

    2015-09-01

    Recently, as an alternative to metal spinal fusion cages, 3D printed bioresorbable materials have been explored; however, the static and fatigue properties of these novel cages are not well known. Unfortunately, current ASTM testing standards used to determine these properties were designed prior to the advent of bioresorbable materials for cages. Therefore, the applicability of these standards for bioresorbable materials is unknown. In this study, an image-based topology and a conventional 3D printed bioresorbable poly(ε)-caprolactone (PCL) cervical cage design were tested in compression, compression-shear, and torsion, to establish their static and fatigue properties. Difficulties were in fact identified in establishing failure criteria and in particular determining compressive failure load. Given these limitations, under static loads, both designs withstood loads of over 650 N in compression, 395 N in compression-shear, and 0.25 Nm in torsion, prior to yielding. Under dynamic testing, both designs withstood 5 million (5M) cycles of compression at 125% of their respective yield forces. Geometry significantly affected both the static and fatigue properties of the cages. The measured compressive yield loads fall within the reported physiological ranges; consequently, these PCL bioresorbable cages would likely require supplemental fixation. Most importantly, supplemental testing methods may be necessary beyond the current ASTM standards, to provide more accurate and reliable results, ultimately improving preclinical evaluation of these devices.

  3. Static and Dynamic Fatigue Behavior of Topology Designed and Conventional 3D Printed Bioresorbable PCL Cervical Interbody Fusion Devices

    PubMed Central

    Knutsen, Ashleen R.; Borkowski, Sean L.; Ebramzadeh, Edward; Flanagan, Colleen L.; Hollister, Scott J.; Sangiorgio, Sophia N.

    2015-01-01

    Recently, as an alternative to metal spinal fusion cages, 3D printed bioresorbable materials have been explored; however, the static and fatigue properties of these novel cages are not well known. Unfortunately, current ASTM testing standards used to determine these properties were designed prior to the advent of bioresorbable materials for cages. Therefore, the applicability of these standards for bioresorbable materials is unknown. In this study, an image-based topology and a conventional 3D printed bioresorbable poly(ε)-caprolactone (PCL) cervical cage design were tested in compression, compression-shear, and torsion, to establish their static and fatigue properties. Difficulties were in fact identified in establishing failure criteria and in particular determining compressive failure load. Given these limitations, under static loads, both designs withstood loads of over 650N in compression, 395N in compression-shear, and 0.25Nm in torsion, prior to yielding. Under dynamic testing, both designs withstood 5 million (5M) cycles of compression at 125% of their respective yield forces. Geometry significantly affected both the static and fatigue properties of the cages. The measured compressive yield loads fall within the reported physiological ranges; consequently, these PCL bioresorbable cages would likely require supplemental fixation. Most importantly, supplemental testing methods may be necessary beyond the current ASTM standards, to provide more accurate and reliable results, ultimately improving preclinical evaluation of these devices. PMID:26072198

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-06-01

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

  6. Ant- and Ant-Colony-Inspired ALife Visual Art.

    PubMed

    Greenfield, Gary; Machado, Penousal

    2015-01-01

    Ant- and ant-colony-inspired ALife art is characterized by the artistic exploration of the emerging collective behavior of computational agents, developed using ants as a metaphor. We present a chronology that documents the emergence and history of such visual art, contextualize ant- and ant-colony-inspired art within generative art practices, and consider how it relates to other ALife art. We survey many of the algorithms that artists have used in this genre, address some of their aims, and explore the relationships between ant- and ant-colony-inspired art and research on ant and ant colony behavior.

  7. Ant- and Ant-Colony-Inspired ALife Visual Art.

    PubMed

    Greenfield, Gary; Machado, Penousal

    2015-01-01

    Ant- and ant-colony-inspired ALife art is characterized by the artistic exploration of the emerging collective behavior of computational agents, developed using ants as a metaphor. We present a chronology that documents the emergence and history of such visual art, contextualize ant- and ant-colony-inspired art within generative art practices, and consider how it relates to other ALife art. We survey many of the algorithms that artists have used in this genre, address some of their aims, and explore the relationships between ant- and ant-colony-inspired art and research on ant and ant colony behavior. PMID:26280070

  8. Biomechanics of lateral interbody spacers: going wider for going stiffer.

    PubMed

    Pimenta, Luiz; Turner, Alexander W L; Dooley, Zachary A; Parikh, Rachit D; Peterson, Mark D

    2012-01-01

    This study investigates the biomechanical stability of a large interbody spacer inserted by a lateral approach and compares the biomechanical differences with the more conventional transforaminal interbody fusion (TLIF), with and without supplemental pedicle screw (PS) fixation. Twenty-four L2-L3 functional spinal units (FSUs) were tested with three interbody cage options: (i) 18 mm XLIF cage, (ii) 26 mm XLIF cage, and (iii) 11 mm TLIF cage. Each spacer was tested without supplemental fixation, and with unilateral and bilateral PS fixation. Specimens were subjected to multidirectional nondestructive flexibility tests to 7.5 N·m. The range of motion (ROM) differences were first examined within the same group (per cage) using repeated-measures ANOVA, and then compared between cage groups. The 26 mm XLIF cage provided greater stability than the 18 mm XLIF cage with unilateral PS and 11 mm TLIF cage with bilateral PS. The 18 mm XLIF cage with unilateral PS provided greater stability than the 11 mm TLIF cage with bilateral PS. This study suggests that wider lateral spacers are biomechanically stable and offer the option to be used with less or even no supplemental fixation for interbody lumbar fusion.

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

    PubMed Central

    2014-01-01

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

  10. Transdural retrieval of a retropulsed lumbar interbody cage: Technical case report

    PubMed Central

    Zaidi, Hasan Aqdas; Shah, Ashish; Kakarla, Udaya Kumar

    2016-01-01

    The purpose of this case report was to describe a novel method to retrieve a herniated lumbar interbody cage. Transforaminal lumbar interbody fusion (TLIF) is an increasingly popular method of spinal fixation and fusion. Unexpected retropulsion of an interbody is a rare event that can result in intractable pain or motor compromise necessitating surgical retrieval of the interbody. Both anterior and posterior approaches to removing migrated cages may be associated with significant surgical morbidity and mortality. A 60-year-old woman underwent an L4-S1 TLIF coupled with pedicle screw fixation at a previous hospital 5 years prior to admission. She noted sudden-onset bilateral lower extremity weakness and right-sided foot drop. Magnetic resonance imaging and radiographs were notable for purely centrally herniated interbody. A posterior, midline transdural approach was used to retrieve the interbody. Situated in between nerve rootlets to the ventral canal, this virgin corridor allowed us to easily visualize and protect neurological structures while safely retrieving the interbody. The patient experienced an immediate improvement in symptoms and was discharged on postoperative day 3. At 12-month follow-up, she had no evidence of cerebrospinal fluid (CSF) leak and had returned to normal activities of daily living. While the risk of CSF leak may be higher with a transdural approach, we maintain that avoiding unnecessary retraction of the nerve roots may outweigh this risk. To our knowledge, this is the first case report of a transdural approach for the retrieval of a retropulsed lumbar interbody cage. PMID:26889290

  11. Lumbar interbody fusion with porous biphasic calcium phosphate enhanced by recombinant bone morphogenetic protein-2/silk fibroin sustained-released microsphere: an experimental study on sheep model.

    PubMed

    Chen, Liang; Liu, Hai-Long; Gu, Yong; Feng, Yu; Yang, Hui-Lin

    2015-03-01

    Biphasic calcium phosphate (BCP) has been investigated extensively as a bone substitute nowadays. However, the bone formation capacity of BCP is limited owing to lack of osteoinduction. Silk fibroin (SF) has a structure similar to type I collagen, and could be developed to a microsphere for the sustained-release of rhBMP-2. In our previous report, bioactivity of BCP could be enhanced by rhBMP-2/SF microsphere (containing 0.5 µg rhBMP-2) in vitro. However, the bone regeneration performance of the composite in vivo was not investigated. Thus, the purpose of this study was to evaluate the efficacy of BCP/rhBMP-2/SF in a sheep lumbar fusion model. A BCP and rhBMP-2/SF microsphere was developed, and then was integrated into a BCP/rhBMP-2/SF composite. BCP, BCP/rhBMP-2 and BCP/rhBMP-2/SF were implanted randomly into the disc spaces of 30 sheep at the levels of L1/2, L3/4 and L5/6. After sacrificed, the fusion segments were evaluated by manual palpation, CT scan, biomechanical testing and histology at 3 and 6 months, respectively. The composite demonstrated a burst-release of rhBMP-2 (39.1 ± 2.8 %) on the initial 4 days and a sustained-release (accumulative 81.3 ± 4.9 %) for more than 28 days. The fusion rates, semi-quantitative CT scores, fusion stiffness in bending in all directions and histologic scores of BCP/rhBMP-2/SF were significantly greater than BCP and BCP/rhBMP-2 at each time point, respectively (P < 0.05). These findings indicate that the SF microspheres containing a very low dose of rhBMP-2 improve fusion in sheep using BCP constructs.

  12. Dynamic stabilization using the Dynesys system versus posterior lumbar interbody fusion for the treatment of degenerative lumbar spinal disease: a clinical and radiological outcomes-based meta-analysis.

    PubMed

    Lee, Chang-Hyun; Jahng, Tae-Ahn; Hyun, Seung-Jae; Kim, Chi Heon; Park, Sung-Bae; Kim, Ki-Jeong; Chung, Chun Kee; Kim, Hyun-Jib; Lee, Soo-Eon

    2016-01-01

    OBJECTIVE The Dynesys, a pedicle-based dynamic stabilization (PDS) system, was introduced to overcome the drawbacks of fusion procedures. Nevertheless, the theoretical advantages of PDS over fusion have not been clearly confirmed. The aim of this study was to compare clinical and radiological outcomes of patients who underwent PDS using the Dynesys system with those who underwent posterior lumbar interbody fusion (PLIF). METHODS The authors searched PubMed, Embase, Web of Science, and the Cochrane Database. Studies that reported outcomes of patients who underwent PDS or PLIF for the treatment of degenerative lumbar spinal disease were included. The primary efficacy end points were perioperative outcomes. The secondary efficacy end points were changes in the Oswestry Disability Index (ODI) and back and leg pain visual analog scale (VAS) scores and in range of motion (ROM) at the treated and adjacent segments. A meta-analysis was performed to calculate weighted mean differences (WMDs), 95% confidence intervals, Q statistics, and I(2) values. Forest plots were constructed for each analysis group. RESULTS Of the 274 retrieved articles, 7 (which involved 506 participants [Dynesys, 250; PLIF, 256]) met the inclusion criteria. The Dynesys group showed a competitive advantage in mean surgery duration (20.73 minutes, 95% CI 8.76-32.70 minutes), blood loss (81.87 ml, 95% CI 45.11-118.63 ml), and length of hospital stay (1.32 days, 95% CI 0.23-2.41 days). Both the Dynesys and PLIF groups experienced improved ODI and VAS scores after 2 years of follow-up. Regarding the ODI and VAS scores, no statistically significant difference was noted according to surgical procedure (ODI: WMD 0.12, 95% CI -3.48 to 3.72; back pain VAS score: WMD -0.15; 95% CI -0.56 to 0.26; leg pain VAS score: WMD -0.07; 95% CI -0.47 to 0.32). The mean ROM at the adjacent segment increased in both groups, and there was no substantial difference between them (WMD 1.13; 95% CI -0.33 to 2.59). Although the

  13. Dynamic stabilization using the Dynesys system versus posterior lumbar interbody fusion for the treatment of degenerative lumbar spinal disease: a clinical and radiological outcomes-based meta-analysis.

    PubMed

    Lee, Chang-Hyun; Jahng, Tae-Ahn; Hyun, Seung-Jae; Kim, Chi Heon; Park, Sung-Bae; Kim, Ki-Jeong; Chung, Chun Kee; Kim, Hyun-Jib; Lee, Soo-Eon

    2016-01-01

    OBJECTIVE The Dynesys, a pedicle-based dynamic stabilization (PDS) system, was introduced to overcome the drawbacks of fusion procedures. Nevertheless, the theoretical advantages of PDS over fusion have not been clearly confirmed. The aim of this study was to compare clinical and radiological outcomes of patients who underwent PDS using the Dynesys system with those who underwent posterior lumbar interbody fusion (PLIF). METHODS The authors searched PubMed, Embase, Web of Science, and the Cochrane Database. Studies that reported outcomes of patients who underwent PDS or PLIF for the treatment of degenerative lumbar spinal disease were included. The primary efficacy end points were perioperative outcomes. The secondary efficacy end points were changes in the Oswestry Disability Index (ODI) and back and leg pain visual analog scale (VAS) scores and in range of motion (ROM) at the treated and adjacent segments. A meta-analysis was performed to calculate weighted mean differences (WMDs), 95% confidence intervals, Q statistics, and I(2) values. Forest plots were constructed for each analysis group. RESULTS Of the 274 retrieved articles, 7 (which involved 506 participants [Dynesys, 250; PLIF, 256]) met the inclusion criteria. The Dynesys group showed a competitive advantage in mean surgery duration (20.73 minutes, 95% CI 8.76-32.70 minutes), blood loss (81.87 ml, 95% CI 45.11-118.63 ml), and length of hospital stay (1.32 days, 95% CI 0.23-2.41 days). Both the Dynesys and PLIF groups experienced improved ODI and VAS scores after 2 years of follow-up. Regarding the ODI and VAS scores, no statistically significant difference was noted according to surgical procedure (ODI: WMD 0.12, 95% CI -3.48 to 3.72; back pain VAS score: WMD -0.15; 95% CI -0.56 to 0.26; leg pain VAS score: WMD -0.07; 95% CI -0.47 to 0.32). The mean ROM at the adjacent segment increased in both groups, and there was no substantial difference between them (WMD 1.13; 95% CI -0.33 to 2.59). Although the

  14. Complications of Lumbar Artificial Disc Replacement Compared to Fusion: Results From the Prospective, Randomized, Multicenter US Food and Drug Administration Investigational Device Exemption Study of the Charité Artificial Disc

    PubMed Central

    Majd, Mohammed E.; Isaza, Jorge E.; Blumenthal, Scott L.; McAfee, Paul C.; Guyer, Richard D.; Hochschuler, Stephen H.; Geisler, Fred H.; Garcia, Rolando; Regan, John J.

    2007-01-01

    Background Previous reports of lumbar total disc replacement (TDR) have described significant complications. The US Food and Drug Administration (FDA) investigational device exemption (IDE) study of the Charité artificial disc represents the first level I data comparison of TDR to fusion. Methods In the prospective, randomized, multicenter IDE study, patients were randomized in a 2:1 ratio, with 205 patients in the Charité group and 99 patients in the control group (anterior lumbar interbody fusion [ALIF] with BAK cages). Inclusion criteria included confirmed single-level degenerative disc disease at L4-5 or L5-S1 and failure of nonoperative treatment for at least 6 months. Complications were reported throughout the study. Results The rate of approach-related complications was 9.8% in the investigational group and 10.1% in the control group. The rate of major neurological complications was similar between the 2 groups (investigational = 4.4%, control = 4.0%). There was a higher rate of superficial wound infection in the investigational group but no deep wound infections in either group. Pseudarthrosis occurred in 9.1% of control group patients. The rate of subsidence in the investigational group was 3.4%. The reoperation rate was 5.4% in the investigational group and 9.1% in the control group. Conclusions The incidence of perioperative and postoperative complications for lumbar TDR was similar to that of ALIF. Vigilance is necessary with respect to patient indications, training, and correct surgical technique to maintain TDR complications at the levels experienced in the IDE study. PMID:25802575

  15. Lumbar interbody expanding cage. A preliminary study on an animal model.

    PubMed

    Manunta, M L; Careddu, G M; Masala, G; Columbano, N; Doria, C; Crissantu, L; Sanna Passino, E

    2008-01-01

    Interbody fusion devices are used in human medicine for treating degenerative diseases of the spine. Currently, there is not a universally accepted assessment tool for determining fusion, and the definitive criteria for diagnosing a successful interbody fusion remain controversial. The aim of this study was to describe microscopic and helical computed tomography (CT) imaging in the assessment of lumbar interbody fusion using cylindrical threaded titanium expanding cage in sheep. One cylindrical threaded expanding titanium cage (Proconcept--SA, Orange, France) was inserted through a transperitoneal approach after radical discectomy and packed with cancellous bone autograft in five adult sheep. The subjects were euthanatized after three, six, 12, 18 and 24 months. CT images revealed lumbar fusion at 12 months post operation, whereas microscopic evaluations indicated the presence of lumbar fusion at 18 months. CT and histological grades were the same in 65% of the cases observed. There were not a significant difference between CT, histological and micro radiographic grades. Helical CT scanning can be considered to be a suitable method for the monitoring of lumbar fusion as it enables observation of the deposition of bony bridging within the cage. PMID:18704248

  16. Biomechanical stability of a bioabsorbable self-retaining polylactic acid/nano-sized β-tricalcium phosphate cervical spine interbody fusion device in single-level anterior cervical discectomy and fusion sheep models

    PubMed Central

    Cao, Lu; Duan, Ping-Guo; Li, Xi-Lei; Yuan, Feng-Lai; Zhao, Ming-Dong; Che, Wu; Wang, Hui-Ren; Dong, Jian

    2012-01-01

    Purpose The aim of this study was to investigate the biomechanical stability provided by a novel, polylactic acid/nano-sized, β-tricalcium phosphate, bioabsorbable, self-retaining cervical fusion cage (BCFC). Methods Quasistatic nonconstraining torques (maximum 1.5 NM) induced flexion, extension, lateral bending (±1.5 NM), and axial rotation (±1.5 NM) on 32 sheep cervical spines (C2–C5). The motion segment C3–C4 was first tested intact; the following groups were tested after complete discectomy: autologous tricortical iliac crest bone graft, Medtronic–Wego polyetheretherketone (PEEK) cage, Solis PEEK cage, and BCFC. The autologous bone graft group was tested with an anterior plate. The mean range of motion (ROM) was calculated from the load-displacement curves. Results BCFC significantly decreased ROM in lateral bending and axial rotation compared to other implants, and no significant difference in ROM between two types of PEEK cages and BCFC could be observed in flexion and extension. Anterior cervical plate (ACP) significantly decreased ROM in flexion and extension, but no significant difference in ROM between BCFC and bone graft plus ACP could be determined in lateral bending and axial rotation. Conclusion The BCFC device showed better stability to autologous tricortical iliac crest bone graft and PEEK cages in single-level anterior cervical discectomy and fusion models and thus may be a potential alternative to the current PEEK cages. PMID:23226018

  17. Mid-range outcomes in 64 consecutive cases of multilevel fusion for degenerative diseases of the lumbar spine

    PubMed Central

    Röllinghoff, Marc; Schlüter-Brust, Klaus; Groos, Daniel; Sobottke, Rolf; Michael, Joern William-Patrick; Eysel, Peer; Delank, Karl Stefan

    2010-01-01

    In the treatment of multilevel degenerative disorders of the lumbar spine, spondylodesis plays a controversial role. Most patients can be treated conservatively with success. Multilevel lumbar fusion with instrumentation is associated with severe complications like failed back surgery syndrome, implant failure, and adjacent segment disease (ASD). This retrospective study examines the records of 70 elderly patients with degenerative changes or instability of the lumbar spine treated between 2002 and 2007 with spondylodesis of more than two segments. Sixty-four patients were included; 5 patients had died and one patient was lost to follow-up. We evaluated complications, clinical/radiological outcomes, and success of fusion. Flexion-extension and standing X-rays in two planes, MRI, and/or CT scans were obtained pre-operatively. Patients were assessed clinically using the Oswestry disability index (ODI) and a Visual Analogue Scale (VAS). Surgery performed was dorsolateral fusion (46.9%) or dorsal fusion with anterior lumbar interbody fusion (ALIF; 53.1%). Additional decompression was carried out in 37.5% of patients. Mean follow-up was 29.4±5.4 months. Average patient age was 64.7±4.3 years. Clinical outcomes were not satisfactory for all patients. VAS scores improved from 8.6±1.3 to 5.6±3.0 pre- to post-operatively, without statistical significance. ODI was also not significantly improved (56.1±22.3 pre- and 45.1±26.4 post-operatively). Successful fusion, defined as adequate bone mass with trabeculation at the facets and transverse processes or in the intervertebral segments, did not correlate with good clinical outcomes. Thirty-five of 64 patients (54%) showed signs of pedicle screw loosening, especially of the screws at S1. However, only 7 of these 35 (20%) complained of corresponding back pain. Revision surgery was required in 24 of 64 patients (38%). Of these, indications were adjacent segment disease (16 cases), pedicle screw loosening (7 cases), and

  18. Medical i2b2 NLP smoking challenge: the A-Life system architecture and methodology.

    PubMed

    Heinze, Daniel T; Morsch, Mark L; Potter, Brian C; Sheffer, Ronald E

    2008-01-01

    We describe the architecture of LifeCode (A-Life Medical, Inc.), a natural language processing system for free-text clinical information extraction, our methodology in applying LifeCode to the i2b2 smoking challenge, and statistical measures for performance evaluation. Due to the limited test size and the coefficient of variation in the test standard, it is difficult to draw conclusions regarding the relative efficacy of approaches that were applied to this challenge.

  19. Evaluation of the 96/4 PLDLLA polymer resorbable lumbar interbody cage in a long term animal model.

    PubMed

    Lazennec, Jean Y; Madi, Abdallah; Rousseau, Marc A; Roger, Bernard; Saillant, Gérard

    2006-10-01

    Arthrodesis using interbody cages has demonstrated high fusion rates. However, permanent cages are exposed to stress-shielding, corrosion, and may require explanation when necessary. Polylactic acid (PLA) bioresorbable cages are developed for avoiding these problems, but significant tissue reaction has been reported with 70/30 PLDLLA in some preclinical animal studies. The objective was to evaluate 96/4 PLDLLA cages in a sheep model over 3 years. Sixteen sheeps underwent one level anterior lumbar interbody fusion using 96/4 PLDLLA cages, filled and surrounded with cancellous bone graft from the iliac crest. Six groups of three animals were killed after 3, 6, 9, 12, 24, and 36 months. Harvested lumbar spine had radiographic, MRI, and CT evaluation and histological analysis. Histological results: cage swelling and slight signs of fragmentation associated to fibrocartilaginous tissue apposition at 3 months; bone remodeling around the cage with direct apposition of the mineralization front at 6 months; active cage degradation and complete fusion around the cage at 9 months; cage fragmentation and partial replacement by bone tissue at 12 months; bone bridges in and around the cage at 24 months; full resorption and intervertebral fusion at 36 months. Radiological results: partial arthrodesis at 3 months; definite peripheral arthrodesis at 6 months; similar aspect at 9 months; significant cage resorption at 12 months; definite inner and outer fusion at 24 months; complete cage resorption and calcification at the location of the cage at 36 months confirmed histological observations. Radiographic, CT scan, MRI, and histological data were consistent for showing progressive resorption of 96/4 PLDLLA, interbody fusion, and bone remodeling, with no significant signs of local intolerance reaction. These results are promising and suggest further development of 96/4 PLDLLA cages. PMID:16736199

  20. 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.

  1. An ecology of text: using text retrieval to study alife on the net.

    PubMed

    Best, M L

    1997-01-01

    I introduce a new alife model, an ecology based on a corpus of text, and apply it to the analysis of posts to USENET News. In this corporal ecology posts are organisms, the newsgroups of NetNews define an environment, and human posters situated in their wider context make up a scarce resource. I apply latent semantic indexing (LSI), a text retrieval method based on principal component analysis, to distill from the corpus those replicating units of text. LSI arrives at suitable replicators because it discovers word co-occurrences that segregate and recombine with appreciable frequency. I argue that natural selection is necessarily in operation because sufficient conditions for its occurrence are met: replication, mutagenicity, and trait/fitness covariance. I describe a set of experiments performed on a static corpus of over 10,000 posts. In these experiments I study average population fitness, a fundamental element of population ecology. My study of fitness arrives at the unhappy discovery that a flame-war, centered around an overly prolific poster, is the king of the jungle. PMID:9654782

  2. [Anterior and posterior stabilization of the lumbosacral spine with the usage of interbody cages in the operational treatment of the isthmic spondylolisthesis].

    PubMed

    Pankowski, Rafał; Smoczyński, Andrzej; Smoczyński, Maciej; Luczkiewicz, Piotr; Piotrowski, Maciej

    2006-01-01

    In the following work results of the operational treatment of the isthmic spondylolisthesis by the posterior stabilization and anterior lumbosacral interbody fusion with the use of interbody implants--cages was taken under evaluation. The test group consisted of 21 patients (13 male and 8 male). The follow up period exceeded 2 years. The objective clinical outcome assessment was based on Oswestry disability questionnaire. Subjective clinical evaluation was done by the visual analog pain score and two questions concerning the evaluation of success of the operative treatment and a possible agreement to a following operation if necessary. The radiological results were done upon evaluation of the degree of the spondylolisthesis, the angle of the lumbosacral lordosis, the height of the interbody space and intervertebral foramen and the evaluation of the spinal fusion. The conclusion was that the usage of the distraction of the lumbosacral spine in the operational treatment of the isthmic spondylolisthesis result in the reduction of the slippage and the dynamic decompression of the compressed neural roots. The usage of the interbody cages prevented the loss of slippage correction, permanently reconstructed the anatomical conditions in the area of the operated spinal segment and helped to achieve good and very good clinical results in over 95% of patients. The fusion rate was 100%. The restoration of the correct height of the intervertebral foramen in the slip segment caused an improvement of the neurologic state. The usage of two level stabilization in the operative treatment of the isthmic spondylolisthesis prevented the initiation of the secondary degenerative changes adjacent to the fusion.

  3. [Mechanical study of spinal interbody implants--characteristics and limits of standardized testing].

    PubMed

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

    2001-11-01

    Spinal interbody fusion has proved to be a useful procedure for the surgical stabilization of spinal segments, for which fusion cases made of metal or reinforced polymers are increasingly being used. For the mechanical testing of spinal interbody implants, a test setup has been developed on the basis of an ASTM proposal. Initially, testing of lumbar fusion cages made of CFRP (carbon fibre reinforced polymer) was carried out. The implants (UNION Cages, Medtronic Sofamor Danek), which are characterised by their radiolucency on radiography, NMR and CT scans, have a cube-shaped body with three table-tracks on the under and upper surfaces. The cages were tested at different loads. Modifications of the proposed standardized method were carried out to enable implementation of implant-oriented testing. The tested cages were shown to have adequate axial compression, shear and torsional strengths with regard to the implant body. The maximum axial compression force tolerated by the table-tracks was less than the maximal potential loading of the lumbar spine, and, with account being taken of implant design, consequences with regard to surgical technique were drawn. As dictated by the geometry of the table-tracks, parallel grooves have to be made intra-operatively in the vertebral end plates. Axial compressive loads then act on the implant body, and the table-tracks are protected from damage. To avoid in vivo failure, the tested cages should be implanted only when this specific surgical technique is employed. Using supplementary anterior or posterior instrumentation, in vivo failure of the table-tracks under physiological spinal loading is not to be expected.

  4. Expandable Polyaryl-Ether-Ether-Ketone Spacers for Interbody Distraction in the Lumbar Spine

    PubMed Central

    Alimi, Marjan; Shin, Benjamin; Macielak, Michael; Hofstetter, Christoph P.; Njoku, Innocent; Tsiouris, Apostolos J.; Elowitz, Eric; Härtl, Roger

    2015-01-01

    Study Design Retrospective case series. Objective StaXx XD (Spine Wave, Inc., Shelton, CT, United States) is an expandable polyaryl-ether-ether-ketone (PEEK) wafer implant utilized in the treatment of lumbar degenerative disease. PEEK implants have been successfully used as interbody devices. Few studies have focused on expandable PEEK devices. The aim of the current study is to determine the radiographic and clinical outcome of expandable PEEK cages utilized for transforaminal lumbar interbody fusion in patients with lumbar degenerative diseases. Methods Forty-nine patients who underwent lumbar interbody fusion with implantation of expandable PEEK cages and posterior instrumentation were included. The clinical outcome was evaluated using the visual analog scale (VAS) and the Oswestry Disability Index (ODI). Radiographic parameters including disk height, foraminal height, listhesis, local disk angle of the index level/levels, regional lumbar lordosis, and graft subsidence were measured preoperatively, postoperatively, and at latest follow-up. Results At an average follow-up of 19.3 months, the minimum clinically important difference for the ODI and VAS back, buttock, and leg were achieved in 64, 52, 58, and 52% of the patients, respectively. There was statistically significant improvement in VAS back (6.42 versus 3.11, p < 0.001), VAS buttock (4.66 versus 1.97, p = 0.002), VAS leg (4.55 versus 1.96, p < 0.001), and ODI (21.7 versus 12.1, p < 0.001) scores. There was a significant increase in the average disk height (6.49 versus 8.18 mm, p = 0.037) and foraminal height (15.6 versus 18.53 mm, p = 0.0001), and a significant reduction in the listhesis (5.13 versus 3.15 mm, p = 0.005). The subsidence of 0.66 mm (7.4%) observed at the latest follow-up was not significant (p = 0.35). Conclusions Midterm results indicate that expandable PEEK spacers can effectively and durably restore disk and foraminal height and improve

  5. Novel spinal instrumentation to enhance osteogenesis and fusion: a preliminary study.

    PubMed

    MacEwan, Matthew R; Talcott, Michael R; Moran, Daniel W; Leuthardt, Eric C

    2016-09-01

    OBJECTIVE Instrumented spinal fusion continues to exhibit high failure rates in patients undergoing multilevel lumbar fusion or pseudarthrosis revision; with Grade II or higher spondylolisthesis; or in those possessing risk factors such as obesity, tobacco use, or metabolic disorders. Direct current (DC) electrical stimulation of bone growth represents a unique surgical adjunct in vertebral fusion procedures, yet existing spinal fusion stimulators are not optimized to enhance interbody fusion. To develop an advanced method of applying DC electrical stimulation to promote interbody fusion, a novel osteogenic spinal system capable of routing DC through rigid instrumentation and into the vertebral bodies was fabricated. A pilot study was designed to assess the feasibility of osteogenic instrumentation and compare the ability of osteogenic instrumentation to promote successful interbody fusion in vivo to standard spinal instrumentation with autograft. METHODS Instrumented, single-level, posterior lumbar interbody fusion (PLIF) with autologous graft was performed at L4-5 in adult Toggenburg/Alpine goats, using both osteogenic spinal instrumentation (plus electrical stimulation) and standard spinal instrumentation (no electrical stimulation). At terminal time points (3 months, 6 months), animals were killed and lumbar spines were explanted for radiographic analysis using a SOMATOM Dual Source Definition CT Scanner and high-resolution Microcat II CT Scanner. Trabecular continuity, radiodensity within the fusion mass, and regional bone formation were examined to determine successful spinal fusion. RESULTS Quantitative analysis of average bone density in pedicle screw beds confirmed that electroactive pedicle screws used in the osteogenic spinal system focally enhanced bone density in instrumented vertebral bodies. Qualitative and quantitative analysis of high-resolution CT scans of explanted lumbar spines further demonstrated that the osteogenic spinal system induced solid

  6. Iatrogenic Baastrup's Syndrome: A Potential Complication Following Anterior Interbody Lumbar Spinal Surgery

    PubMed Central

    Russo, Glenn S.; Castro, Carlos A.

    2015-01-01

    Background Baastrup's Syndrome is a condition that occurs when there is abnormal contact between two adjacent spinous processes resulting in back pain. An alteration in lumbar spinal alignment and/or adjacent segment compensatory motion is thought to be potential causative factors. The objective of this study was to present a case series of what appears to be iatrogenic Baastrup's Syndrome as a mid-to-late term complication following anterior lumbar interbody surgery. Methods A retrospective chart review was performed of all patients undergoing anterior lumbar surgery for either fusion or disc replacement to determine the prevalence of Baastrup's Syndrome. Results Over a 12-year period, 855 patients who had undergone an anterior approach for lumbar spine surgery were identified. Of them 8 patients with evidence of Baastrup's Syndrome were found; this demonstrated a prevalence of 0.9%. Diagnostic injection was a helpful clinical tool in confirming the diagnosis of iatrogenic Baastrup's Syndrome. The partial removal of the impinging spinous processes resulted in excellent clinical relief. Conclusions Iatrogenic Baastrup's Syndrome may be an iatrogenic result of anterior lumbar surgery in small group of patients. Spinous process excision is a suggested treatment option. Further studies are necessary to explore the above phenomenon. This study is a Level 3 retrospective case series. PMID:26767158

  7. More nerve root injuries occur with minimally invasive lumbar surgery: Let's tell someone

    PubMed Central

    Epstein, Nancy E.

    2016-01-01

    Background: In a recent study entitled: “More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion (XLIF): A review”, Epstein documented that more nerve root injuries occurred utilizing minimally invasive surgery (MIS) versus open lumbar surgery for diskectomy, decompression of stenosis (laminectomy), and/or fusion for instability. Methods: In large multicenter Spine Patient Outcomes Research Trial reviews performed by Desai et al., nerve root injury with open diskectomy occurred in 0.13–0.25% of cases, occurred in 0% of laminectomy/stenosis with/without fusion cases, and just 2% for open laminectomy/stenosis/degenerative spondylolisthesis with/without fusion. Results: In another MIS series performed largely for disc disease (often contained nonsurgical disc herniations, therefore unnecessary procedures) or spondylolisthesis, the risk of root injury was 2% for transforaminal lumbar interbody fusion (TLIF) versus 7.8% for posterior lumbar interbody fusion (PLIF). Furthermore, the high frequencies of radiculitis/nerve root/plexus injuries incurring during anterior lumbar interbody fusions (ALIF: 15.8%) versus extreme lumbar interbody fusions (XLIF: 23.8%), addressing disc disease, failed back surgery, and spondylolisthesis, were far from acceptable. Conclusions: The incidence of nerve root injuries following any of the multiple MIS lumbar surgical techniques (TLIF/PLIF/ALIF/XLIF) resulted in more nerve root injuries when compared with open conventional lumbar surgical techniques. Considering the majority of these procedures are unnecessarily being performed for degenerative disc disease alone, spine surgeons should be increasingly asked why they are offering these operations to their patients? PMID:26904373

  8. Spinal fusion

    MedlinePlus

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

  9. Study ethnomathematics of aboge (alif, rebo, wage) calendar as determinant of the great days of Islam and traditional ceremony in Cirebon Kasepuhan Palace

    NASA Astrophysics Data System (ADS)

    Syahrin, Muhammad Alfi; Turmudi, Puspita, Entit

    2016-02-01

    This research attempts to show about the relationship between mathematics and culture. Paradigm that emerged currently, that mathematics is an abstract concept and difficult, therefore mathematics is not favored by most students. In the reality, indirectly mathematics is present in a culture of a society. Ethnomathematics study is a study to examine how does a group of people in a particular culture understand, express, and use the concepts and practices of culture that depicted mathematically. This research was conducted in Cirebon precisely in Kasepuhan Palace, which was in RW 04, Kasepuhan village, Lemah Wungkuk district, Cirebon city, West Java. The focus of the study and research purposes was the application of aboge (alif rebo wage) calendar as the calculation of days and the calendar rules determine the time of days, great days of Islam and traditional ceremony in Kasepuhan Palace. Qualitative methods with the principles of ethnography such as studies in ethnomathematics i.e observation, interviews, documentation and fieldnotes were used in this research. The findings of this ethnomathematics study show that the determining great days of Islam and the days of palace traditional ceremony have a close relationship with the counts and principles in mathematics. This study provides recommendations that mathematics is closely related to culture due to ethnomathematics.

  10. Computational analyses of different intervertebral cages for lumbar spinal fusion.

    PubMed

    Bashkuev, Maxim; Checa, Sara; Postigo, Sergio; Duda, Georg; Schmidt, Hendrik

    2015-09-18

    Lumbar spinal fusion is the most common approach for treating spinal disorders such as degeneration or instability. Although this procedure has been performed for many years, there are still important challenges that must be overcome and questions that need to be addressed regarding the high rates of non-union. The present finite element model study aimed to investigate the influence of different cage designs on the fusion process. An axisymmetric finite element model of a spinal segment with an interbody fusion cage was used. The fusion process was based on an existing mechano-regulation algorithm for tissue formation. With this model, the following principal concepts of cage design were investigated: (1) different cage geometries with constant compressive stiffness and (2) cage designs optimized to provide the ideal mechanical stimulus for bone formation, first at the beginning of fusion and then throughout the entire fusion process. The cage geometry substantially influenced the fusion outcome. A cage that created an optimized initial mechanical stimulus did not necessarily lead to accelerated fusion, but rather resulted in delayed fusion or non-union. In contrast, a cage made of a degradable material produced a significantly higher amount of bone and resulted in higher segmental stiffness. However, different compressive loads (250, 500 and 1000 N) substantially affected the amount of newly formed bone tissue. The results of the present study suggest that aiming for an optimal initial mechanical stimulus may be misleading because the initial mechanical environment is not preserved throughout the bone modeling process.

  11. Absorbable anterior cervical plate for corpectomy and fusion in a 2-year-old child with neurofibromatosis. Technical note.

    PubMed

    Lidar, Zvi; Constantini, Shlomi; Regev, Gilad J; Salame, Khalil

    2012-04-01

    Postlaminectomy cervical kyphosis is one of the most challenging entities in spine surgery. Correction of this deformity usually requires anterior fusion with plating and a strut graft or interbody cage and posterior fusion with screws and rods. The situation is more complicated in the young child because fusion may affect future growth of the cervical spine. There is also a paucity of adequate instrumentation for the small bony structures. Some authors have reported utilization of absorbable cervical plates for fusion in pediatric patients with favorable results. The authors present a modified surgical technique that was used for circumferential fusion in a 2-year-old girl with cervical kyphosis and recurrent neurofibroma. Anterior fusion was performed using an autologous rib graft and an absorbable cervical plate. This was followed by posterior fusion using rib bone and cables. Previous reports on the use of absorbable cervical plates are reviewed and the advantages of the current technique are discussed. PMID:22462712

  12. Biomechanical evaluation of a spherical lumbar interbody device at varying levels of subsidence

    PubMed Central

    Rundell, Steven A.; Isaza, Jorge E.; Kurtz, Steven M.

    2011-01-01

    Background Ulf Fernström implanted stainless steel ball bearings following discectomy, or for painful disc disease, and termed this procedure disc arthroplasty. Today, spherical interbody spacers are clinically available, but there is a paucity of associated biomechanical testing. The primary objective of the current study was to evaluate the biomechanics of a spherical interbody implant. It was hypothesized that implantation of a spherical interbody implant, with combined subsidence into the vertebral bodies, would result in similar ranges of motion (RoM) and facet contact forces (FCFs) when compared with an intact condition. A secondary objective of this study was to determine the effect of using a polyetheretherketone (PEEK) versus a cobalt chrome (CoCr) implant on vertebral body strains. We hypothesized that the material selection would have a negligible effect on vertebral body strains since both materials have elastic moduli substantially greater than the annulus. Methods A finite element model of L3-L4 was created and validated by use of ROM, disc pressure, and bony strain from previously published data. Virtual implantation of a spherical interbody device was performed with 0, 2, and 4 mm of subsidence. The model was exercised in compression, flexion, extension, axial rotation, and lateral bending. The ROM, vertebral body effective (von Mises) strain, and FCFs were reported. Results Implantation of a PEEK implant resulted in slightly lower strain maxima when compared with a CoCr implant. For both materials, the peak strain experienced by the underlying bone was reduced with increasing subsidence. All levels of subsidence resulted in ROM and FCFs similar to the intact model. Conclusions The results suggest that a simple spherical implant design is able to maintain segmental ROM and provide minimal differences in FCFs. Large areas of von Mises strain maxima were generated in the bone adjacent to the implant regardless of whether the implant was PEEK or Co

  13. Stability and Load Sharing Characteristics of a Posterior Dynamic Stabilization Device

    PubMed Central

    Cook, Daniel J.; Yeager, Matthew S.; Thampi, Shankar S.; Whiting, Donald M.

    2015-01-01

    Background Lumbar interbody fusion is a common treatment for a variety of spinal pathologies. It has been hypothesized that insufficient mechanical loading of the interbody graft can prevent proper fusion of the joint. The purpose of this study was to evaluate the mechanical stability and anterior column loading sharing characteristics of a posterior dynamic system compared to titanium rods in an anterior lumbar interbody fusion (ALIF) model. Methods Range of motion, interpedicular kinematics and interbody graft loading were measured in human cadaveric lumbar segments tested under a pure moment flexibility testing protocol. Results Both systems provided significant fixation compared to the intact condition and to an interbody spacer alone in flexion extension and lateral bending. No significant differences in fixation were detected between the devices. A significant decrease in graft loading was detected in flexion for the titanium rod treatment compared to spacer alone. No significant differences in graft loading were detected between the spacer alone and posterior dynamic system or between the posterior dynamic system and the titanium rod. Conclusions The results of this study indicate that the posterior dynamic system provides similar fixation compared to that of a titanium rod, however, studies designed to evaluate the efficacy of fixation in a cadaver model may not be sufficiently powered to establish differences in load sharing using the techniques described here. PMID:26131403

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

    PubMed Central

    Epstein, Nancy Ellen

    2016-01-01

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

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

    PubMed Central

    Epstein, Nancy E.

    2016-01-01

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

  16. Big fusion, little fusion

    NASA Astrophysics Data System (ADS)

    Chen, Frank; ddtuttle

    2016-08-01

    In reply to correspondence from George Scott and Adam Costley about the Physics World focus issue on nuclear energy, and to news of construction delays at ITER, the fusion reactor being built in France.

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

    PubMed

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

    2016-05-01

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

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

    PubMed

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

    2016-05-01

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

  19. National trends in revision spinal fusion in the USA: patient characteristics and complications.

    PubMed

    Rajaee, S S; Kanim, L E A; Bae, H W

    2014-06-01

    Using the United States Nationwide Inpatient Sample, we identified national trends in revision spinal fusion along with a comprehensive comparison of comorbidities, inpatient complications and surgical factors of revision spinal fusion compared to primary spinal fusion. In 2009, there were 410 158 primary spinal fusion discharges and 22 128 revision spinal fusion discharges. Between 2002 and 2009, primary fusion increased at a higher rate compared with revision fusion (56.4% vs 51.0%; p < 0.001). In 2009, the mean length of stay and hospital charges were higher for revision fusion discharges than for primary fusion discharges (4.2 days vs 3.8 days, p < 0.001; USD $91 909 vs. $87 161, p < 0.001). In 2009, recombinant human bone morphogenetic protein (BMP) was used more in revision fusion than in primary fusion (39.6% vs 27.6%, p < 0.001), whereas interbody devices were used less in revision fusion (41.8% vs 56.6%, p < 0.001). In the multivariable logistic regression model for all spinal fusions, depression (odds ratio (OR) 1.53, p < 0.001), psychotic disorders (OR 1.49, p < 0.001), deficiency anaemias (OR 1.35, p < 0.001) and smoking (OR 1.10, p = 0.006) had a greater chance of occurrence in revision spinal fusion discharges than in primary fusion discharges, adjusting for other variables. In terms of complications, after adjusting for all significant comorbidities, this study found that dural tears (OR 1.41; p < 0.001) and surgical site infections (OR 3.40; p < 0.001) had a greater chance of occurrence in revision spinal fusion discharges than in primary fusion discharges (p < 0.001). A p-value < 0.01 was considered significant in all final analyses.

  20. Shape optimization for the subsidence resistance of an interbody device using simulation-based genetic algorithms and experimental validation.

    PubMed

    Hsu, Ching-Chi

    2013-07-01

    Subsidence of interbody devices into the vertebral body might result in serious clinical problems, especially when the devices are not well designed and analyzed. Recently, some novel designs were proposed to reduce the risk of subsidence, but those designs are based on the researcher's experience. The purpose of this study was to discover the interbody device design with excellent subsidence resistance by changing the device's shape. The three-dimensional nonlinear finite element models, which consisted of the interbody device and vertebral body, were created first. Then, the simulation-based genetic algorithm, which combined the finite element model and the searching algorithm, was developed by using ANSYS® Parametric Design Language. Finally, the numerical results were carefully validated with the use of biomechanical tests. The optimum shape design obtained in this study looks like a flower with many petals and it has excellent subsidence resistance when compared with the other designs provided by the past studies. The results of the present study could help surgeons to understand the subsidence resistance of interbody devices in terms of their shapes and has directly provided the design rationales to engineers.

  1. Early experience with endoscopic revision of lumbar spinal fusions.

    PubMed

    McGrath, Lynn B; Madhavan, Karthik; Chieng, Lee Onn; Wang, Michael Y; Hofstetter, Christoph P

    2016-02-01

    Approximately half a million spinal fusion procedures are performed annually in the US. It is estimated that up to one-third of arthrodesis constructs require revision surgeries. In this study the authors present endoscopic treatment strategies targeting 3 types of complications following arthrodesis surgery: 1) adjacent-level foraminal stenosis; 2) foraminal stenosis at an arthrodesis segment; and 3) stenosis caused by a displaced interbody cage. A retrospective chart review of 11 patients with a mean age of 68 ± 15 years was performed (continuous variables are shown as the mean ± SEM). All patients had a history of lumbar arthrodesis surgery and suffered from unilateral radiculopathy. Endoscopic revision surgeries were done as outpatient procedures, and there were no intraoperative or perioperative complications. The cohort included 3 patients with foraminal stenosis at the level of previous arthrodesis. They presented with unilateral radicular leg pain (visual analog scale [VAS] score: 7.3 ± 2.1) and were severely disabled, as evidenced by an Oswestry Disability Index (ODI) of 46 ± 4.9. Transforaminal endoscopic foraminotomies were performed, and at a mean follow-up time of 9.0 ± 2.5 months VAS was reduced by an average of 6.3. The cohort also includes 7 patients suffering unilateral radiculopathy due to adjacent-level foraminal stenosis. Preoperative VAS for leg pain of the symptomatic side was 6.0 ± 1.6, VAS for back pain was 5.2 ± 1.7, and ODI was 40 ± 6.33. Endoscopic decompression led to reduction of the ipsilateral leg VAS score by an average of 5, resulting in leg pain of 1 ± 0.5 at an average of 8 months of follow-up. The severity of back pain remained stable (VAS 4.2 ± 1.4). Two of these patients required revision surgery for recurrent symptoms. Finally, this study includes 1 patient who presented with weakness and pain due to retropulsion of an L5/S1 interbody spacer. The patient underwent an endoscopic interlaminar approach with partial

  2. Nuclear Fusion

    NASA Astrophysics Data System (ADS)

    Veres, G.

    This chapter is devoted to the fundamental concepts of nuclear fusion. To be more precise, it is devoted to the theoretical basics of fusion reactions between light nuclei such as hydrogen, helium, boron, and lithium. The discussion is limited because our purpose is to focus on laboratory-scale fusion experiments that aim at gaining energy from the fusion process. After discussing the methods of calculating the fusion cross section, it will be shown that sustained fusion reactions with energy gain must happen in a thermal medium because, in beam-target experiments, the energy of the beam is randomized faster than the fusion rate. Following a brief introduction to the elements of plasma physics, the chapter is concluded with the introduction of the most prominent fusion reactions ongoing in the Sun.

  3. Comparison of Fusion Rates between Glycerol-Preserved and Frozen Composite Allografts in Cervical Fusion.

    PubMed

    Rodway, Ian; Gander, Julie

    2014-01-01

    Background. This retrospective, two cohort series study was designed to compare a room temperature, glycerol-preserved composite pinned bone allograft (G-CPBA) with the same graft type provided in a frozen state (F-CPBA) for use as a cervical interbody spacer in anterior cervical discectomy and fusion (ACDF). Methods. A comprehensive chart review was performed for 67 sequential patients that received either a F-CPBA or a G-CPBA and had at least one-year follow-up. Twenty-eight patients had received G-CPBA grafts and 37 patients had received F-CPBA grafts. Two additional 2-level patients had received one of each type of grafts. Results. At 3 months, 45.3% (29 of 64) of glycerol-preserved and 41.4% (29 of 70) of frozen allografts, respectively, were considered to be fused radiographically. At 12 months, 100% of both treatment groups (41 glycerol-preserved and 45 frozen) were considered fused. Fusion rates for G-CPBA were statistically similar to F-CPBA at both 3 and 12 months (P = 0.6535 and >0.999, resp.). There were no allograft related complications in either treatment group. Conclusions. 100% fusion rates were attained by both treatment groups at 12 months and were similar at short-term follow-up for all comparable levels. Level of Evidence. Level of evidence is III.

  4. Comparison of Fusion Rates between Glycerol-Preserved and Frozen Composite Allografts in Cervical Fusion

    PubMed Central

    Rodway, Ian; Gander, Julie

    2014-01-01

    Background. This retrospective, two cohort series study was designed to compare a room temperature, glycerol-preserved composite pinned bone allograft (G-CPBA) with the same graft type provided in a frozen state (F-CPBA) for use as a cervical interbody spacer in anterior cervical discectomy and fusion (ACDF). Methods. A comprehensive chart review was performed for 67 sequential patients that received either a F-CPBA or a G-CPBA and had at least one-year follow-up. Twenty-eight patients had received G-CPBA grafts and 37 patients had received F-CPBA grafts. Two additional 2-level patients had received one of each type of grafts. Results. At 3 months, 45.3% (29 of 64) of glycerol-preserved and 41.4% (29 of 70) of frozen allografts, respectively, were considered to be fused radiographically. At 12 months, 100% of both treatment groups (41 glycerol-preserved and 45 frozen) were considered fused. Fusion rates for G-CPBA were statistically similar to F-CPBA at both 3 and 12 months (P = 0.6535 and >0.999, resp.). There were no allograft related complications in either treatment group. Conclusions. 100% fusion rates were attained by both treatment groups at 12 months and were similar at short-term follow-up for all comparable levels. Level of Evidence. Level of evidence is III. PMID:27382618

  5. Foraminal height measurement techniques

    PubMed Central

    Phan, Kevin; Rao, Prashanth J.

    2015-01-01

    Background One of the proposed advantages of anterior lumbar interbody fusion (ALIF) is restoration of disc height and hence an indirect foraminal height restoration. While this proposed advantage is often quoted in the literature, there are few robust studies demonstrating restoration of foraminal volume. Thus, this study aimed to review the literature and discuss the progression and development of foramen measurement techniques. Methods A review of the literature was performed to identify studies which reported foraminal height and dimensions following fusion surgery in cadaveric models or patients. Results Techniques in prior studies used to quantify foraminal dimensions before and after fusion operations include analysis from plain radiographs, computed tomography (CT) scans and magnetic resonance imaging (MRI) scans. Recent studies have attempted to standardize foraminal dimension measurements with the use of orthogonal software, accelerator-based measurements and the use of multiple images for three-dimensional reconstruction of the foramen volume. Conclusions Consistent results have demonstrated significant increases in foraminal area and height following anterior lumbar interbody distraction, providing evidence that ALIF can indirectly increase foraminal height. Future studies should use standardized measurement approaches such as the Pedicle-to-Pedicle technique with CT or MRI images to determine changes in foraminal dimensions.

  6. Foraminal height measurement techniques

    PubMed Central

    Phan, Kevin; Rao, Prashanth J.

    2015-01-01

    Background One of the proposed advantages of anterior lumbar interbody fusion (ALIF) is restoration of disc height and hence an indirect foraminal height restoration. While this proposed advantage is often quoted in the literature, there are few robust studies demonstrating restoration of foraminal volume. Thus, this study aimed to review the literature and discuss the progression and development of foramen measurement techniques. Methods A review of the literature was performed to identify studies which reported foraminal height and dimensions following fusion surgery in cadaveric models or patients. Results Techniques in prior studies used to quantify foraminal dimensions before and after fusion operations include analysis from plain radiographs, computed tomography (CT) scans and magnetic resonance imaging (MRI) scans. Recent studies have attempted to standardize foraminal dimension measurements with the use of orthogonal software, accelerator-based measurements and the use of multiple images for three-dimensional reconstruction of the foramen volume. Conclusions Consistent results have demonstrated significant increases in foraminal area and height following anterior lumbar interbody distraction, providing evidence that ALIF can indirectly increase foraminal height. Future studies should use standardized measurement approaches such as the Pedicle-to-Pedicle technique with CT or MRI images to determine changes in foraminal dimensions. PMID:27683677

  7. Fusion Implementation

    SciTech Connect

    J.A. Schmidt

    2002-02-20

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

  8. A prospective, multi-center clinical and radiographic outcomes evaluation of ChronOS strip for lumbar spine fusion.

    PubMed

    Kanter, Adam S; Gandhoke, Gurpreet S; Welch, William C; Arnold, Paul M; Cheng, Joseph S; Okonkwo, David O

    2016-03-01

    This prospective clinical study evaluated the use of a composite bone void filler (ChronOS Strip, DePuy Synthes, West Chester, PA, USA), combined with bone marrow aspirate plus local autologous bone, in a series of patients undergoing instrumented posterolateral spinal fusion with interbody support. Seventy-six patients were enrolled and treated per protocol at 13 clinical sites. At 24 months, 55/76 patients (72%) were evaluated, with 49/76 (65%) having sufficient data to determine the primary endpoint. The primary endpoint, posterolateral fusion success, was achieved in 48/54 (88.9%) patients at 12 months and in 45/49 (91.8%) patients at 24 months. At all follow-up time points, statistically significant improvements were observed when compared to baseline in back and leg pain and functional status as measured by visual analog scale, Oswestry Disability Index and 12-Item Short Form health surveys. This prospective multi-center series provides evidence that the composite bone void filler, when applied posterolaterally with instrumentation, bone marrow aspirate and/or local autologous bone and concomitant interbody support, can be used to achieve a successful posterolateral fusion, resulting in improvements in clinical outcomes in patients with degenerative disc disease.

  9. Fast degradable citrate-based bone scaffold promotes spinal fusion

    PubMed Central

    Tang, Jiajun; Guo, Jinshan; Li, Zhen; Yang, Cheng; Xie, Denghui; Chen, Jian; Li, Shengfa; Li, Shaolin; Kim, Gloria B.; Bai, Xiaochun; Zhang, Zhongmin; Yang, Jian

    2015-01-01

    It is well known that high rates of fusion failure and pseudoarthrosis development (5~35%) are concomitant in spinal fusion surgery, which was ascribed to the shortage of suitable materials for bone regeneration. Citrate was recently recognized to play an indispensable role in enhancing osteconductivity and osteoinductivity, and promoting bone formation. To address the material challenges in spinal fusion surgery, we have synthesized mechanically robust and fast degrading citrate-based polymers by incorporating N-methyldiethanolamine (MDEA) into clickable poly(1, 8-octanediol citrates) (POC-click), referred to as POC-M-click. The obtained POC-M-click were fabricated into POC-M-click-HA matchstick scaffolds by compositing with hydroxyapatite (HA) for interbody spinal fusion in a rabbit model. Spinal fusion was analyzed by radiography, manual palpation, biomechanical testing, and histological evaluation. At 4 and 8 weeks post surgery, POC-M-click-HA scaffolds presented optimal degradation rates that facilitated faster new bone formation and higher spinal fusion rates (11.2±3.7, 80±4.5 at week 4 and 8, respectively) than the poly(L-lactic acid)-HA (PLLA-HA) control group (9.3±2.4 and 71.1±4.4) (p<0.05). The POC-M-click-HA scaffold-fused vertebrates possessed a maximum load and stiffness of 880.8±14.5 N and 843.2±22.4 N/mm, respectively, which were also much higher than those of the PLLA-HA group (maximum: 712.0±37.5 N, stiffness: 622.5±28.4 N/mm, p<0.05). Overall, the results suggest that POC-M-click-HA scaffolds could potentially serve as promising bone grafts for spinal fusion applications. PMID:26213625

  10. Image fusion

    NASA Technical Reports Server (NTRS)

    Pavel, M.

    1993-01-01

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

  11. Magnetic resonance imaging on disc degeneration changes after implantation of an interspinous spacer and fusion of the adjacent segment

    PubMed Central

    Liu, Xiaokang; Liu, Yingjie; Lian, Xiaofeng; Xu, Jianguang

    2015-01-01

    The aim of the study was to investigate the changes of the lumbar intervertebral disc degeneration by magnetic resonance imaging (MRI) after the implantation of interspinous device and the fusion of the adjacent segment. A total of 62 consecutive patients suffering L5/S1 lumbar disc herniation (LDH) with concomitant disc space narrowing or low-grade instability up to 5 mm translational slip in L5/S1 level were treated with lumbar interbody fusion (LIF) via posterior approach. Thirty-four of these patients (Coflex group) received an additional implantation of the interspinous spacer device (Coflex™) in the level L4/L5, while the rest of 28 patients (fusion group) underwent the fusion surgery alone. Clinical and radiographic examinations were performed at pre- and postoperative visits to compare the clinical outcomes and the changes of the L4/L5 vertebral disc degeneration on MRI in both Coflex and fusion group. Although both Coflex and fusion group showed improvements of the clinical outcomes assessed by the Oswestry Disability Index (ODI) after surgery, patients in Coflex group had more significant amelioration (P < 0.05) compared to fusion group. During follow up, the postoperative disc degeneration changes in Coflex group assessed by the relative signal intensity (RSI) differed from those in fusion group (P < 0.05). The supplemental implantation of Coflex™ after the fusion surgery could delay the disc degeneration of the adjacent segment. PMID:26131210

  12. Magnetic resonance imaging on disc degeneration changes after implantation of an interspinous spacer and fusion of the adjacent segment.

    PubMed

    Liu, Xiaokang; Liu, Yingjie; Lian, Xiaofeng; Xu, Jianguang

    2015-01-01

    The aim of the study was to investigate the changes of the lumbar intervertebral disc degeneration by magnetic resonance imaging (MRI) after the implantation of interspinous device and the fusion of the adjacent segment. A total of 62 consecutive patients suffering L5/S1 lumbar disc herniation (LDH) with concomitant disc space narrowing or low-grade instability up to 5 mm translational slip in L5/S1 level were treated with lumbar interbody fusion (LIF) via posterior approach. Thirty-four of these patients (Coflex group) received an additional implantation of the interspinous spacer device (Coflex™) in the level L4/L5, while the rest of 28 patients (fusion group) underwent the fusion surgery alone. Clinical and radiographic examinations were performed at pre- and postoperative visits to compare the clinical outcomes and the changes of the L4/L5 vertebral disc degeneration on MRI in both Coflex and fusion group. Although both Coflex and fusion group showed improvements of the clinical outcomes assessed by the Oswestry Disability Index (ODI) after surgery, patients in Coflex group had more significant amelioration (P < 0.05) compared to fusion group. During follow up, the postoperative disc degeneration changes in Coflex group assessed by the relative signal intensity (RSI) differed from those in fusion group (P < 0.05). The supplemental implantation of Coflex™ after the fusion surgery could delay the disc degeneration of the adjacent segment.

  13. Fusion Power.

    ERIC Educational Resources Information Center

    Dingee, David A.

    1979-01-01

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

  14. Anterior cervical interbody constructs: effect of a repetitive compressive force on the endplate.

    PubMed

    Ordway, Nathaniel R; Rim, Byeong Cheol; Tan, Rong; Hickman, Rebecca; Fayyazi, Amir H

    2012-04-01

    Graft subsidence following anterior cervical reconstruction can result in the loss of sagittal balance and recurring foraminal stenosis. This study examined the implant-endplate interface using a cyclic fatigue loading protocol in an attempt to model the subsidence seen in vivo. The superior endplate from 30 cervical vertebrae (C3 to T1) were harvested and biomechanically tested in axial compression with one of three implants: Fibular allograft; titanium mesh cage packed with cancellous chips; and trabecular metal. Each construct was cyclically loaded from 50 to 250 N for 10,000 cycles. Nondestructive cyclic loading of the cervical endplate-implant construct resulted in a stiffer construct independent of the type of the interbody implant tested. The trabecular metal construct demonstrated significantly more axial stability and significantly less subsidence in comparison to the titanium mesh construct. Although the allograft construct resulted in more subsidence than the trabecular metal construct, the difference was not significant and no difference was found when comparing axial stability. For all constructs, the majority of the subsidence during the cyclic testing occurred during the first 500 cycles and was followed by a more gradual settling in the remaining 9,500 cycles.

  15. Laser fusion

    SciTech Connect

    Smit, W.A.; Boskma, P.

    1980-12-01

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

  16. Retroperitoneal fluid collection following anterior spine surgery--differential and management.

    PubMed

    VanValkenburg, Scott; Trussell, J C; Lavelle, William F

    2016-04-01

    Iatrogenic ureteral injuries are rare and must be accurately identified to minimizing the risk for additional complications. Anterior lumbar interbody fusion (ALIF) is a valuable technique utilized in spine surgery, with its own unique set of complications. For example, retroperitoneal fluid collections, following ALIF surgery are rare and may result in back pain, radicular pain, nausea, and even death. It is important to rapidly identify the nature of the fluid collection to clarify appropriate management options. The purpose of this case report is to present a differential diagnosis for a delayed presentation of an extremely large retroperitoneal fluid collection following anterior lumbar surgery, as well as to provide discussion on this rare complication. Specifically, a 51-year-old female with a history of numerous previous abdominal surgeries underwent an L3-S1 ALIF through a paramedian retroperitoneal approach. Postoperatively, she developed a large retroperitoneal fluid collection heralded by unilateral left lower extremity swelling and paresthesias. Fluid aspiration suggested a urine leak, but no specific injury was identified on retrograde pyelogram, most likely due to hardware obscuration in the area of presumed injury. A presumptive ureteral injury resulted in a ureteral stent placement, with resolution of the fluid collection and hydronephrosis. A high index of suspicion allowed for proper treatment, healing, and ultimately, a satisfactory outcome. PMID:27085832

  17. [Stiffening effect of a transsacral fusion system for the lumbosacral junction. A probabilistic finite element analysis and sensitivity study].

    PubMed

    Boustani, H N; Rohlmann, A; Abouezzeddine, O; Bergmann, G; Zander, T

    2011-02-01

    The novel transsacral fusion system AxiALIF allows stabilization of the lumbosacral junction. The system consists of a screw with two different diameters. With additional facet screws or internal fixation devices 360° fusion can be achieved. The effects of different parameters such as length, diameter combination and material of the transsacral screw, type of additional fixation and stiffness of the bone are unknown. In a probabilistic finite element analysis, the input parameters were randomly varied. The rotational angles and the axial forces in the various implants were calculated for four different load scenarios. In a subsequent sensitivity study the influences of single input parameters on the variance of the results were calculated. A transsacral screw significantly reduces the motion in the treated segment, except for axial rotation. An additional fixation has a strong effect on the variance of rotation angles. The other parameters usually explain less than 10% of the variance. The novel lumbosacral fusion system allows good stabilization of the segment, especially when additional fixation via facet screws or fixators is performed.

  18. Off-label innovation: characterization through a case study of rhBMP-2 for spinal fusion.

    PubMed

    Schnurman, Zane; Smith, Michael L; Kondziolka, Douglas

    2016-09-01

    OBJECTIVE Off-label therapies are widely used in clinical practice by spinal surgeons. Some patients and practitioners have advocated for increased regulation of their use, and payers have increasingly questioned reimbursment for off-label therapies. In this study, the authors applied a model that quantifies publication data to analyze the developmental process from initial on-label use to off-label innovation, using as an example recombinant human bone morphogenetic protein 2 (rhBMP-2) because of its wide off-label use. METHODS As a case study of off-label innovation, the developmental patterns of rhBMP-2 from FDA-approved use for anterior lumbar interbody fusion to several of its off-label uses, including posterolateral lumbar fusion, anterior cervical discectomy and fusion, and posterior lumbar interbody fusion/transforaminal lumbar interbody fusion, were evaluated using the "progressive scholarly acceptance" (PSA) model. In this model, PSA is used as an end point indicating acceptance of a therapy or procedure by the relevant scientific community and is reached when the total number of peer-reviewed studies devoted to refinement or improvement of a therapy surpasses the total number assessing initial efficacy. Report characteristics, including the number of patients studied and study design, were assessed in addition to the time to and pattern of community acceptance, and results compared with previous developmental study findings. Disclosures and reported conflicts of interest for all articles were reviewed, and these data were also used in the analysis. RESULTS Publication data indicated that the acceptance of rhBMP-2 off-label therapies occurred more rapidly and with less evidence than previously studied on-label therapies. Additionally, the community appeared to respond more robustly (by rapidly changing publication patterns) to reports of adverse events than to new questions of efficacy. CONCLUSIONS The development of off-label therapies, including the

  19. Off-label innovation: characterization through a case study of rhBMP-2 for spinal fusion.

    PubMed

    Schnurman, Zane; Smith, Michael L; Kondziolka, Douglas

    2016-09-01

    OBJECTIVE Off-label therapies are widely used in clinical practice by spinal surgeons. Some patients and practitioners have advocated for increased regulation of their use, and payers have increasingly questioned reimbursment for off-label therapies. In this study, the authors applied a model that quantifies publication data to analyze the developmental process from initial on-label use to off-label innovation, using as an example recombinant human bone morphogenetic protein 2 (rhBMP-2) because of its wide off-label use. METHODS As a case study of off-label innovation, the developmental patterns of rhBMP-2 from FDA-approved use for anterior lumbar interbody fusion to several of its off-label uses, including posterolateral lumbar fusion, anterior cervical discectomy and fusion, and posterior lumbar interbody fusion/transforaminal lumbar interbody fusion, were evaluated using the "progressive scholarly acceptance" (PSA) model. In this model, PSA is used as an end point indicating acceptance of a therapy or procedure by the relevant scientific community and is reached when the total number of peer-reviewed studies devoted to refinement or improvement of a therapy surpasses the total number assessing initial efficacy. Report characteristics, including the number of patients studied and study design, were assessed in addition to the time to and pattern of community acceptance, and results compared with previous developmental study findings. Disclosures and reported conflicts of interest for all articles were reviewed, and these data were also used in the analysis. RESULTS Publication data indicated that the acceptance of rhBMP-2 off-label therapies occurred more rapidly and with less evidence than previously studied on-label therapies. Additionally, the community appeared to respond more robustly (by rapidly changing publication patterns) to reports of adverse events than to new questions of efficacy. CONCLUSIONS The development of off-label therapies, including the

  20. Clinical outcomes following sublaminar decompression and instrumented fusion for lumbar degenerative spinal pathology.

    PubMed

    Peddada, Kranti; Elder, Benjamin D; Ishida, Wataru; Lo, Sheng-Fu L; Goodwin, C Rory; Boah, Akwasi O; Witham, Timothy F

    2016-08-01

    Traditional treatment for lumbar stenosis with instability is laminectomy and posterolateral arthrodesis, with or without interbody fusion. However, laminectomies remove the posterior elements and decrease the available surface area for fusion. Therefore, a sublaminar decompression may be a preferred approach for adequate decompression while preserving bone surface area for fusion. A retrospective review of 71 patients who underwent sublaminar decompression in conjunction with instrumented fusion for degenerative spinal disorders at a single institution was performed. Data collected included demographics, preoperative symptoms, operative data, and radiographical measurements of the central canal, lateral recesses, and neural foramina, and fusion outcomes. Paired t-tests were used to test significance of the outcomes. Thirty-one males and 40 females with a median age 60years underwent sublaminar decompression and fusion. A median of two levels were fused. The mean Visual Analog Scale pain score improved from 6.7 preoperatively to 2.9 at last follow-up. The fusion rate was 88%, and the median time to fusion was 11months. Preoperative and postoperative mean thecal sac cross-sectional area, right lateral recess height, left lateral recess height, right foraminal diameter, and left foraminal diameter were 153 and 209mm(2) (p<0.001), 5.9 and 5.9mm (p=0.43), 5.8 and 6.3mm (p=0.027), 4.6 and 5.2mm (p=0.008), and 4.2 and 5.2mm (p<0.001), respectively. Sublaminar decompression provided adequate decompression, with significant increases in thecal sac cross-sectional area and bilateral foraminal diameter. It may be an effective alternative to laminectomy in treating central and foraminal stenosis in conjunction with instrumented fusion.

  1. Cold fusion, Alchemist's dream

    SciTech Connect

    Clayton, E.D.

    1989-09-01

    In this report the following topics relating to cold fusion are discussed: muon catalysed cold fusion; piezonuclear fusion; sundry explanations pertaining to cold fusion; cosmic ray muon catalysed cold fusion; vibrational mechanisms in excited states of D{sub 2} molecules; barrier penetration probabilities within the hydrogenated metal lattice/piezonuclear fusion; branching ratios of D{sub 2} fusion at low energies; fusion of deuterons into {sup 4}He; secondary D+T fusion within the hydrogenated metal lattice; {sup 3}He to {sup 4}He ratio within the metal lattice; shock induced fusion; and anomalously high isotopic ratios of {sup 3}He/{sup 4}He.

  2. Polyetheretherketone (PEEK) cage filled with cancellous allograft in anterior cervical discectomy and fusion

    PubMed Central

    Liao, Jen-Chung; Chen, Wen-Jer; Chen, Lih-Huei

    2007-01-01

    From July 2004 to June 2005, 19 patients with 25 discs underwent anterior cervical discectomy and interbody fusion (ACDF) in which polyetheretherketone (PEEK) cages were filled with freeze-dried cancellous allograft bone. This kind of bone graft was made from femoral condyle that was harvested during total knee arthroplasty. Patient age at surgery was 52.9 (28–68) years. All patients were followed up at least 1 year. We measured the height of the disc and segmental sagittal angulation by pre-operative and post-operative radiographs. CT scan of the cervical spine at 1 year was used to evaluate fusion rates. Odom's criteria were used to assess the clinical outcome. All interbody disc spaces achieved successful union at 1-year follow-up. The use of a PEEK cage was found to increase the height of the disc immediately after surgery (5.0 mm pre-operatively, 7.3 mm immediately post-operatively). The final disc height was 6.2 mm, and the collapse of the disc height was 1.1 mm. The segmental lordosis also increased after surgery (2.0° pre-operatively, 6.6° immediately post-operatively), but the mean loss of lordosis correction was 3.3° at final follow-up. Seventy-four percent of patients (14/19) exhibited excellent/good clinical outcomes. Analysis of the results indicated the cancellous allograft bone-filled PEEK cage used in ACDF is a good choice for patients with cervical disc disease, and avoids the complications of harvesting iliac autograft. PMID:17639386

  3. Protoplast Fusion

    PubMed Central

    Yamada, Yasuyuki; Hara, Yasuhiro; Katagi, Hiroaki; Senda, Mitsugi

    1980-01-01

    The relation between the composition of the phospholipid molecular species in a cell membrane and the velocity of protoplast fusion was studied using cells cultured at a low temperature (10 C). Cells cultured at a low temperature contained larger proportions of phospholipids of low phase transition point, the 1,2-dilinoleoyl-type, than those cultured at a normal temperature (25 C). When treated with polyethylene glycol 6000, protoplasts from cells cultured at 10 C fused and progressed to the fused sphere stage more rapidly than did those from cells cultured at 25 C. PMID:16661339

  4. Splenogonadal fusion.

    PubMed

    Tsingoglou, S; Wilkinson, A W

    1976-04-01

    The fusion between splenic tissue and the left gonad or the derivatives of the left mesonephros is a rare congenital anomaly first described in detail by Pommer in 1887/9 and divided into two forms by Putschar and Manion in 1956. In the first or continuous type a cord of splenic or fibrous tissue connects the spleen and the gonadalmesonephric structures. In the second type the fused splenomesonephric structures have lost continuity with the main spleen. An example of the continuous form is presented and the previous reports are briefly reviewed.

  5. Pedicle-Screw-Based Dynamic Systems and Degenerative Lumbar Diseases: Biomechanical and Clinical Experiences of Dynamic Fusion with Isobar TTL

    PubMed Central

    Barrey, Cédric; Perrin, Gilles; Champain, Sabina

    2013-01-01

    Dynamic systems in the lumbar spine are believed to reduce main fusion drawbacks such as pseudarthrosis, bone rarefaction, and mechanical failure. Compared to fusion achieved with rigid constructs, biomechanical studies underlined some advantages of dynamic instrumentation including increased load sharing between the instrumentation and interbody bone graft and stresses reduction at bone-to-screw interface. These advantages may result in increased fusion rates, limitation of bone rarefaction, and reduction of mechanical complications with the ultimate objective to reduce reoperations rates. However published clinical evidence for dynamic systems remains limited. In addition to providing biomechanical evaluation of a pedicle-screw-based dynamic system, the present study offers a long-term (average 10.2 years) insight view of the clinical outcomes of 18 patients treated by fusion with dynamic systems for degenerative lumbar spine diseases. The findings outline significant and stable symptoms relief, absence of implant-related complications, no revision surgery, and few adjacent segment degenerative changes. In spite of sample limitations, this is the first long-term report of outcomes of dynamic fusion that opens an interesting perspective for clinical outcomes of dynamic systems that need to be explored at larger scale. PMID:25031874

  6. Durotomy is associated with pseudoarthrosis following lumbar fusion.

    PubMed

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

    2015-03-01

    Pseudoarthrosis is a known complication following lumbar fusion, and although several risk factors have been established, the association of durotomy and pseudoarthrosis has not been studied to our knowledge. A retrospective review was performed to identify all adult patients who underwent lumbar posterolateral fusion (without interbody fusion) for degenerative spine disease over a 20 year period at a single institution. Patients were divided into durotomy and no durotomy cohorts. Patients were included if they had at least 1 year of follow-up. The main outcome variable was development of pseudoarthrosis. A total of 327 patients were identified, of whom 17 (5.19%) had a durotomy. Pseudoarthrosis rates were significantly higher in the durotomy group (35.29%) when compared to the no durotomy group (13.87%), with the difference being statistically significant (p=0.016). Univariate analysis revealed that durotomy (p=0.003) and the number of levels fused (p=0.015) were the only two significant risk factors for pseudoarthrosis. After controlling for the number of levels fused, the adjusted relative risk (RR) revealed that patients with a durotomy were 2.23 times more likely to develop pseudoarthrosis (RR 2.23; 95% confidence interval 1.05-4.75) when compared to patients without durotomy. The findings in the present study suggest an association between durotomy and pseudoarthrosis development. Patients with a durotomy were 2.2 times more likely to develop pseudoarthrosis compared to patients without a durotomy. Future and larger studies are required to corroborate our findings.

  7. A meta-analysis of artificial total disc replacement versus fusion for lumbar degenerative disc disease

    PubMed Central

    Yajun, Wu; Xiuxin, Han; Cui, Cui

    2010-01-01

    Lumbar fusion has been developed for several decades and became the standard surgical treatment for symptomatic lumbar degenerative disc disease (DDD). Artificial total disc replacement (TDR), as an alternative for spinal arthrodesis, is becoming more commonly employed treating lumbar DDD. It is still uncertain whether TDR is more effective and safer than lumbar fusion. To systematically compare the effectiveness and safety of TDR to that of the fusion for the treatment of lumbar DDD, we performed a meta-analysis. Cochrane review methods were used to analyze all relevant randomized controlled trials published up to July 2009. Five relevant randomized controlled trials involving 837 patients were identified. Patients in TDR group have sightly better functioning and less back or leg pain without clinical significance, and significantly higher satisfaction status in TDR group compared with lumbar fusion group at the 2-year follow-up. But these outcomes are highly influenced by the study with BAK cage interbody fusion, the function/pain and patient satisfaction status are no longer significantly different between two groups after excluding this study. At 5 years, these outcomes are not significantly different between comparing groups. The complication and reoperation rate of two groups are similar both at 2 and at 5 years. In conclusion, TDR does not show significant superiority for the treatment of lumbar DDD compared with fusion. The benefits of motion preservation and the long-term complications are still unable to be concluded. More high-quality RCTs with long-term follow-up are needed. PMID:20364392

  8. Fusion energy

    NASA Astrophysics Data System (ADS)

    1990-09-01

    The main purpose of the International Thermonuclear Experimental Reactor (ITER) is to develop an experimental fusion reactor through the united efforts of many technologically advanced countries. The ITER terms of reference, issued jointly by the European Community, Japan, the USSR, and the United States, call for an integrated international design activity and constitute the basis of current activities. Joint work on ITER is carried out under the auspices of the International Atomic Energy Agency (IAEA), according to the terms of quadripartite agreement reached between the European Community, Japan, the USSR, and the United States. The site for joint technical work sessions is at the Max Planck Institute of Plasma Physics. Garching, Federal Republic of Germany. The ITER activities have two phases: a definition phase performed in 1988 and the present design phase (1989 to 1990). During the definition phase, a set of ITER technical characteristics and supporting research and development (R and D) activities were developed and reported. The present conceptual design phase of ITER lasts until the end of 1990. The objectives of this phase are to develop the design of ITER, perform a safety and environmental analysis, develop site requirements, define future R and D needs, and estimate cost, manpower, and schedule for construction and operation. A final report will be submitted at the end of 1990. This paper summarizes progress in the ITER program during the 1989 design phase.

  9. Fusion energy

    SciTech Connect

    Not Available

    1990-09-01

    The main purpose of the International Thermonuclear Experimental Reactor (ITER) is to develop an experimental fusion reactor through the united efforts of many technologically advanced countries. The ITER terms of reference, issued jointly by the European Community, Japan, the USSR, and the United States, call for an integrated international design activity and constitute the basis of current activities. Joint work on ITER is carried out under the auspices of the International Atomic Energy Agency (IAEA), according to the terms of quadripartite agreement reached between the European Community, Japan, the USSR, and the United States. The site for joint technical work sessions is at the MaxPlanck Institute of Plasma Physics. Garching, Federal Republic of Germany. The ITER activities have two phases: a definition phase performed in 1988 and the present design phase (1989--1990). During the definition phase, a set of ITER technical characteristics and supporting research and development (R D) activities were developed and reported. The present conceptual design phase of ITER lasts until the end of 1990. The objectives of this phase are to develop the design of ITER, perform a safety and environmental analysis, develop site requirements, define future R D needs, and estimate cost, manpower, and schedule for construction and operation. A final report will be submitted at the end of 1990. This paper summarizes progress in the ITER program during the 1989 design phase.

  10. Osteoconductive hydroxyapatite coated PEEK for spinal fusion surgery

    NASA Astrophysics Data System (ADS)

    Hahn, Byung-Dong; Park, Dong-Soo; Choi, Jong-Jin; Ryu, Jungho; Yoon, Woon-Ha; Choi, Joon-Hwan; Kim, Jong-Woo; Ahn, Cheol-Woo; Kim, Hyoun-Ee; Yoon, Byung-Ho; Jung, In-Kwon

    2013-10-01

    Polyetheretherketone (PEEK) has attracted much interest as biomaterial for interbody fusion cages due to its similar stiffness to bone and good radio-transparency for post-op visualization. Hydroxyapatite (HA) coating stimulates bone growth to the medical implant. The objective of this work is to make an implant consisting of biocompatible PEEK with an osteoconductive HA surface for spinal or orthopedic applications. Highly dense and well-adhered HA coating was developed on medical-grade PEEK using aerosol deposition (AD) without thermal degradation of the PEEK. The HA coating had a dense microstructure with no cracks or pores, and showed good adhesion to PEEK at adhesion strengths above 14.3 MPa. The crystallinity of the HA coating was remarkably enhanced by hydrothermal annealing as post-deposition heat-treatment. In addition, in vitro and in vivo biocompatibility of PEEK, in terms of cell adhesion morphology, cell proliferation, differentiation, and bone-to-implant contact ratio, were remarkably enhanced by the HA coating through AD.

  11. Recombinant Human Bone Morphogenetic Protein-2 in Posterolateral Spinal Fusion: What's the Right Dose?

    PubMed Central

    Jones, Clifford Barry; Sietsema, Debra Lynn

    2016-01-01

    Study Design Single center retrospective cohort analysis. Purpose The goal was to evaluate the influence of varying amount of recombinant human bone morphogenetic protein 2 (rhBMP-2) per level on fusion rates and complications in posterolateral spinal fusions. Overview of Literature rhBMP-2 has been utilized for lumbar posterolateral fusions for many years. Initial rhBMP-2 recommendations were 20 mg/level of fusion. Dose and concentration per level in current studies vary from 4.2 to 40 mg and 1.5 to 2.0 mg/mL, respectively. Variable fusion and complication rates have been reported. Methods Patients (n=1,610) undergoing instrumented lumbar spinal fusion (2003–2009) with utilization of rhBMP-2 were retrospectively evaluated. Patient demographics, body mass index (BMI), comorbidities, number of levels, associated interbody fusion, and types of bone void filler were analyzed. Fusions rates and nonunions were subdivided into number of levels and amount of rhBMP-2 used per level. Results Patients (n=559) were evaluated with 58.5% females having an average age of 63 years, BMI of 31 kg/m2. Number of levels fused ranged from 1 to 8. rhBMP-2 averaged 7.3 mg/level (range, 1.5–24 mg/level) based upon length of collagen sponge in relation to length of fusion levels. Patients with non-union formation had lower rhBMP-2 dose per level (p=0.016). A significant difference in non-union rate was found between patients undergoing fusion with <6 mg/level compared to those with >6 mg/level (9.1% vs. 2.4%, χ2=0.012). No significant differences were noted between 6–11.9 mg/level and ≥12 mg/level. No threshold was found for seroma formation or bone overgrowth. Conclusions Previous recommendation of 20 mg/level of rhBMP-2 is more than what is required for predictable fusion rates of 98%. No dose related increase of infection, seroma formation, and bone overgrowth has been found. In order to provide variable dosing and cost reduction, industry generated rhBMP-2 kit size should be

  12. Viral membrane fusion.

    PubMed

    Harrison, Stephen C

    2015-05-01

    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 formed 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.

  13. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 3: assessment of economic outcome.

    PubMed

    Ghogawala, Zoher; Whitmore, Robert G; Watters, William C; Sharan, Alok; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Eck, Jason C; Groff, Michael W; Wang, Jeffrey C; Resnick, Daniel K; Dhall, Sanjay S; Kaiser, Michael G

    2014-07-01

    A comprehensive economic analysis generally involves the calculation of indirect and direct health costs from a societal perspective as opposed to simply reporting costs from a hospital or payer perspective. Hospital charges for a surgical procedure must be converted to cost data when performing a cost-effectiveness analysis. Once cost data has been calculated, quality-adjusted life year data from a surgical treatment are calculated by using a preference-based health-related quality-of-life instrument such as the EQ-5D. A recent cost-utility analysis from a single study has demonstrated the long-term (over an 8-year time period) benefits of circumferential fusions over stand-alone posterolateral fusions. In addition, economic analysis from a single study has found that lumbar fusion for selected patients with low-back pain can be recommended from an economic perspective. Recent economic analysis, from a single study, finds that femoral ring allograft might be more cost-effective compared with a specific titanium cage when performing an anterior lumbar interbody fusion plus posterolateral fusion.

  14. Magneto-Inertial Fusion

    DOE PAGESBeta

    Wurden, G. A.; Hsu, S. C.; Intrator, T. P.; Grabowski, T. C.; Degnan, J. H.; Domonkos, M.; Turchi, P. J.; Campbell, E. M.; Sinars, D. B.; Herrmann, M. C.; et al

    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). The status of MIF research in North America at multiple institutions is summarized including recent progress, research opportunities, and future plans.

  15. Hot and cold fusion

    SciTech Connect

    Not Available

    1990-08-01

    This article presents an overview of research in cold fusion research and development in cold fusion at the Tokomak Fusion Test Reactor at the Princeton Plasma Physics Lab, and at the inertial containment facility at Lawrence Livermore National Lab. is described.

  16. Using Provocative Discography and Computed Tomography to Select Patients with Refractory Discogenic Low Back Pain for Lumbar Fusion Surgery.

    PubMed

    Xi, Mengqiao Alan; Tong, Henry C; Fahim, Daniel K; Perez-Cruet, Mick

    2016-01-01

    Background Context Controversy remains over the use of provocative discography in conjunction with computed tomography (CT) to locate symptomatic intervertebral discs in patients with chronic, low back pain (LBP). The current study explores the relationship between discogenic pain and disc morphology using discography and CT, respectively, and investigates the efficacy of this combined method in identifying surgical candidates for lumbar fusion by evaluating outcomes. Methods 43 consecutive patients between 2006 and 2013 who presented with refractory low back pain and underwent discography and CT were enrolled in the study. For this study, "refractory LBP" was defined as pain symptoms that persisted or worsened after 6 months of non-operative treatments. Concordant pain was defined as discography-provoked LBP of similar character and location with an intensity of ≥ 8/10. Fusion candidates demonstrated positive-level discography and concordant annular tears on CT at no more than two contiguous levels, and at least one negative control disc with intact annulus. Surgical outcomes were statistically analyzed using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) for back-related pain and disability preoperatively, and 2 weeks, 3, 6, 12, and 24 months postoperatively. Results Annular tears were found in 87 discs. Concordant pain was reported by 9 (20.9%) patients at L3-L4, 21 (50.0%) at L4-L5, and 34 (82.9%) at L5-S1; pain occurred significantly more often in discs with annular tears than those without (p<0.001). Painless discs were independent of annulus status (p=0.90). 18 (42%) of the original 43 patients underwent lumbar fusion at L3-L4 (n=1(6%)), L4-L5 (n=6 (33%)), L5-S1 (n=5 (28%)), and two-level L4-S1 (n=6 (33%)) via a minimally invasive transforaminal lumbar interbody fusion (MITLIF) approach with the aim to replace the nucleus pulposus with bone graft material. Median follow-up time was 18 months (range: 12-78 months

  17. Viral membrane fusion

    SciTech Connect

    Harrison, Stephen C.

    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 formed 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.

  18. The fusion breeder

    NASA Astrophysics Data System (ADS)

    Moir, Ralph W.

    1982-10-01

    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 U.S. fusion energy program. This paper suggests it is time for a policy change to make the fusion breeder a goal of the U.S. fusion program and the U.S. nuclear energy program. There is wide agreement that many approaches will work and will produce fuel for five equal-sized LWRs, and some approach as many as 20 LWRs at electricity costs within 20% of those at today's price of uranium (30/lb of U3O8). The blankets designed to suppress fissioning, called symbiotes, fusion fuel factories, or just fusion breeders, will have safety characteristics more like pure fusion reactors and will support as many as 15 equal power LWRs. The blankets designed to maximize fast fission of fertile material will have safety characteristics more like fission reactors and will support 5 LWRs. This author strongly recommends development of the fission suppressed blanket type, a point of view not agreed upon by everyone. There is, however, wide agreement that, to meet the market price for uranium which would result in LWR electricity within 20% of today's cost with either blanket type, fusion components can cost severalfold more than would be allowed for pure fusion to meet the goal of making electricity alone at 20% over today's fission costs. Also widely agreed is that the critical-path-item for the fusion breeder is fusion development itself; however, development of fusion breeder specific items (blankets, fuel cycle) should be started now in order to have the fusion breeder by the time the rise in uranium prices forces other more costly choices.

  19. Materials research for fusion

    NASA Astrophysics Data System (ADS)

    Knaster, J.; Moeslang, A.; Muroga, T.

    2016-05-01

    Fusion materials research started in the early 1970s following the observation of the degradation of irradiated materials used in the first commercial fission reactors. The technological challenges of fusion energy are intimately linked with the availability of suitable materials capable of reliably withstanding the extremely severe operational conditions of fusion reactors. Although fission and fusion materials exhibit common features, fusion materials research is broader. The harder mono-energetic spectrum associated with the deuterium-tritium fusion neutrons (14.1 MeV compared to <2 MeV on average for fission neutrons) releases significant amounts of hydrogen and helium as transmutation products that might lead to a (at present undetermined) degradation of structural materials after a few years of operation. Overcoming the historical lack of a fusion-relevant neutron source for materials testing is an essential pending step in fusion roadmaps. Structural materials development, together with research on functional materials capable of sustaining unprecedented power densities during plasma operation in a fusion reactor, have been the subject of decades of worldwide research efforts underpinning the present maturity of the fusion materials research programme.

  20. 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.

  1. Fusion facility siting considerations

    NASA Astrophysics Data System (ADS)

    Bussell, G. T.

    1985-02-01

    Inherent in the fusion program's transition from hydrogen devices to commercial power machines is a general increase in the size and scope of succeeding projects. This growth will lead to increased emphasis on safety, environmental impact, and the external effects of fusion in general, and of each new device in particular. An important consideration in this regard is site selection. Major siting issues that may affect the economics, safety, and environmental impact of fusion are examined.

  2. Status of fusion maintenance

    SciTech Connect

    Fuller, G.M.

    1984-01-01

    Effective maintenance will be an essential ingredient in determining fusion system productivity. This level of productivity will result only after close attention is paid to the entire system as an entity and appropriate integration of the elements is made. The status of fusion maintenance is reviewed in the context of the entire system. While there are many challenging developmental tasks ahead in fusion maintenance, the required technologies are available in several high-technology industries, including nuclear fission.

  3. Fusion: The controversy continues

    SciTech Connect

    1989-07-01

    Nuclear fusion-the power of the stars that promises mankind an inexhaustible supply of energy-seems concurrently much closer and still distant this month. The recent flurry of announcements concerning the achievement of a cold fusion reaction has-if nothing else-underscored the historic importance of the basic fusion reaction which uses hydrogen ions to fuel an energy-producing reaction.

  4. 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.

  5. Meteorite fusion crust variability.

    NASA Astrophysics Data System (ADS)

    Thaisen, Kevin G.; Taylor, Lawrence A.

    2009-06-01

    Two assumptions commonly employed in meteorite interpretation are that fusion crust compositions represent the bulk-rock chemistry of the interior meteorite and that the vesicles within the fusion crust result from the release of implanted solar wind volatiles. Electron microprobe analyses of thin sections from lunar meteorite Miller Range (MIL) 05035 and eucrite Bates Nunataks (BTN) 00300 were performed to determine if the chemical compositions of the fusion crust varied and/or represented the published bulk rock composition. It was determined that fusion crust compositions are significantly influenced by the incorporation of fragments from the substrate, and by the composition and grain size of those minerals. Because of compositional heterogeneities throughout the meteorite, one cannot assume that fusion crust composition represents the bulk rock composition. If the compositional variability within the fusion crust and mineralogical differences among thin sections goes unnoticed, then the perceived composition and petrogenetic models of formation will be incorrect. The formation of vesicles within these fusion crusts were also compared to current theories attributing vesicles to a solar wind origin. Previous work from the STONE-5 experiment, where terrestrial rocks were exposed on the exterior of a spacecraft heatshield, produced a vesicular fusion crust without prolonged exposure to solar wind suggesting that the high temperatures experienced by a meteorite during passage through the Earth's atmosphere are sufficient to cause boiling of the melt. Therefore, the assumption that all vesicles found within a fusion crust are due to the release of implanted volatiles of solar wind may not be justified.

  6. Coatings for laser fusion

    SciTech Connect

    Lowdermilk, W.H.

    1981-12-18

    Optical coatings are used in lasers systems for fusion research to control beam propagation and reduce surface reflection losses. The performance of coatings is important in the design, reliability, energy output, and cost of the laser systems. Significant developments in coating technology are required for future lasers for fusion research and eventual power reactors.

  7. 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.

  8. Controlled Nuclear Fusion.

    ERIC Educational Resources Information Center

    Glasstone, Samuel

    This publication is one of a series of information booklets for the general public published by The United States Atomic Energy Commission. Among the topics discussed are: Importance of Fusion Energy; Conditions for Nuclear Fusion; Thermonuclear Reactions in Plasmas; Plasma Confinement by Magnetic Fields; Experiments With Plasmas; High-Temperature…

  9. Two Horizons of Fusion

    ERIC Educational Resources Information Center

    Lo, Mun Ling; Chik, Pakey Pui Man

    2016-01-01

    In this paper, we aim to differentiate the internal and external horizons of "fusion." "Fusion" in the internal horizon relates to the structure and meaning of the object of learning as experienced by the learner. It clarifies the interrelationships among an object's critical features and aspects. It also illuminates the…

  10. Degenerative Spondylolisthesis: Does Fusion Method Influence Outcome? Four-Year Results of the Spine Patient Outcomes Research Trial (SPORT)

    PubMed Central

    Abdu, William A.; Lurie, Jon D.; Spratt, Kevin F.; Tosteson, Anna N.A.; Zhao, Wenyan; Tosteson, Tor D.; Herkowitz, Harry; Longely, Michael; Boden, Scott D.; Emery, Sanford; Weinstein, James N.

    2013-01-01

    Study Design Clinical trial sub-group analysis Objective To compare outcomes of different fusion techniques treating degenerative spondylolisthesis (DS). Summary of Background Data Surgery has been shown to be more effective than non-operative treatment out to four years.1,2 Questions remain regarding the differential effect of fusion technique. METHODS Surgical candidates from 13 centers in 11 states with at least 12 weeks of symptoms and confirmatory imaging showing stenosis and DS were studied. In addition to standard decompressive laminectomy, one of three fusion techniques was employed at the surgeon’s discretion: posterolateral in situ fusion (PLF); posterolateral instrumented fusion with pedicle screws (PPS); or PPS plus interbody fusion (360°). Main outcome measures were the SF-36 Bodily Pain (BP) and Physical Function (PF) scales and the modified Oswestry Disability Index (ODI) assessed at 6 weeks, 3 months, 6 months, and yearly to 4 years. The as-treated analysis combined the randomized and observational cohorts using mixed longitudinal models adjusting for potential confounders. RESULTS Of 380 surgical patients, 21% (N= 80) received a PLF; 56% (N=213) received a PPS; 17% (N=63) received a 360°; and 6% (N=23) had decompression only without fusion. Early outcomes varied, favoring PLF compared to PPS at 6 weeks (PF: 12.73 vs. 6.22, p<0.020) and 3 months (PF: 25.24 vs.18.95, p<0.025) and PPS compared to 360° at 6 weeks (ODI: −14.46 vs. −9.30, p<0.03) and 3 months (ODI: −22.30 vs. −16.78, p<0.02). At two years, 360° had better outcomes: BP: 39.08 vs. 29.17 PLF, p<0.011; and vs. 29.13 PPS, p<0.002; PF; 31.93 vs. 23.27 PLF, p<0.021; and vs. 25.29 PPS, p<0.036. However, these differences were not maintained at 3- and 4-year follow-up, when there were no statistically significant differences between the three fusion groups. CONCLUSIONS In patients with degenerative spondylolisthesis and associated spinal stenosis, no consistent differences in

  11. Fusion Physics Toward ITER

    NASA Astrophysics Data System (ADS)

    Stambaugh, R. D.

    2006-04-01

    Stars are powered by fusion, the energy released by fusing together light nuclei, using gravitational confinement of plasma. Fusion on earth will be done in a 100 million degree plasma made of deuterium and tritium and confined by magnetic fields or inertia. The worldwide fusion research community will construct ITER, the first experiment that will burn a DT plasma by copious fusion reactions. ITER's nominal goal is to create 500 MW of fusion power. An energy gain of 10 will mean the plasma is dominantly self-heated by the fusion-produced alpha particles. ITER's all superconducting magnet technology and steady-state heat removal technology will enable nominal 400 s pulses to allow the study of burning plasmas on the longest intrinsic timescale of the confined plasma - diffusive redistribution of the electrical currents in the plasma. The advances in magnetic confinement physics that have led to this opportunity will be described, as well as the research opportunities afforded by ITER. The physics of confining stable plasmas and heating them will produce the high gain state in ITER. Sustained burn will come from the physics of controlling currents in plasmas and how the hot plasma is interfaced to its room temperature surroundings. ITER will provide our first experience with how fusion plasma self-heating will profoundly affect the complex, interlinked physical processes that occur in confined plasmas.

  12. 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.

  13. Study on the anatomy of the lumbosacral anterior great vessels pertinent to L5/S1 anterior interbody surgery with computer tomography angiography.

    PubMed

    Liu, Liehua; Liang, Yong; Zhou, Qiang; Zhang, Hong; Wang, Haoming; Li, Songtao; Zhao, Chen; Hou, Tianyong; Liu, Ling

    2014-12-01

    We investigate the anatomy of the lumbosacral anterior great vessels using computer tomography (CT) angiography before L5/S1 anterior interbody surgery. Sixty-two adult patients were selected. The location of the abdominal aortic bifurcation and common iliac venous confluence in the lumbar vertebrae and the anatomic parameters of the iliac vascular space (e.g., distances from the included angle vertex of the iliac vascular space to the median sagittal plane and to the inferior boundary of L5 and distances between the left and right iliac vessels on the inferior boundary of L5 and on the superior boundary of S1) were analysed. Overall, 67.73% of the 62 cases had an abdominal aortic bifurcation located at L4 and L4/5 intervertebral disc; 61.29%, the common iliac venous confluence located at L5. The four distances mentioned above were 0.98 cm ± 0.38 cm, 2.01 cm ± 1.26 cm, 3.11 cm ± 1.35 cm and 4.34 cm ± 1.10 cm, respectively. A classification system of types A, B and C was developed. The calculated L5/S1 intervertebral space exposure percentages of types A, B and C were 32.21%, 82.58% and 54.68%, respectively. During L5/S1 anterior interbody surgery, type B intervertebral discs can be exposed conveniently, preventing injury of the iliac vessels, which was also observed in 54.68% and 32.21% of the type C and type A discs, respectively. Because the type A intervertebral disc has minimal exposure, the risk of iliac vascular injury is relatively high in these patients.

  14. Spherical torus fusion reactor

    DOEpatents

    Martin Peng, Y.K.M.

    1985-10-03

    The object of this invention is to provide a compact torus fusion reactor with dramatic simplification of plasma confinement design. Another object of this invention is to provide a compact torus fusion reactor with low magnetic field and small aspect ratio stable plasma confinement. In accordance with the principles of this invention there is provided a compact toroidal-type plasma confinement fusion reactor in which only the indispensable components inboard of a tokamak type of plasma confinement region, mainly a current conducting medium which carries electrical current for producing a toroidal magnet confinement field about the toroidal plasma region, are retained.

  15. Some new inequalities for continuous fusion frames and fusion pairs.

    PubMed

    Zhang, Wei; Li, Yun-Zhang

    2016-01-01

    This paper addresses continuous fusion frames and fusion pairs which are extensions of discrete fusion frames and continuous frames. The study of equalities and inequalities for various frames has seen great achievements. In this paper, using operator methods we establish some new inequalities for continuous fusion frames and fusion pairs. Our results extend and improve ones obtained by Balan, Casazza and Găvruţa. PMID:27652173

  16. Inertial fusion commercial power plants

    NASA Astrophysics Data System (ADS)

    Logan, B. Grant

    1994-09-01

    This presentation discusses the motivation for inertial fusion energy, a brief synopsis of five recently-completed inertial fusion power plant designs, some general conclusions drawn from these studies, and an exmaple of an IEE hydrogen synfuel plant to suggest that future fusion studies consider broadening fusion use to low-emission fuels production as well as electricity.

  17. Label fusion strategy selection.

    PubMed

    Robitaille, Nicolas; Duchesne, Simon

    2012-01-01

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

  18. Fusion-power demonstration

    NASA Astrophysics Data System (ADS)

    Henning, C. D.; Logan, B. G.; Carlson, G. A.; Neef, W. S.; Moir, R. W.; Campbell, R. B.; Botwin, R.; Clarkson, I. R.; Carpenter, T. J.

    1983-03-01

    As a satellite to the MARS (Mirror Advanced Reactor Study) a smaller, near-term device has been scoped, called the FPD (Fusion Power Demonstration). Envisioned as the next logical step toward a power reactor, it would advance the mirror fusion program beyond MFTF-B and provide an intermediate step toward commercial fusion power. Breakeven net electric power capability would be the goal such that no net utility power would be required to sustain the operation. A phased implementation is envisioned, with a deuterium checkout first to verify the plasma systems before significant neutron activation has occurred. Major tritium-related facilities would be installed with the second phase to produce sufficient fusion power to supply the recirculating power to maintain the neutral beams, ECRH, magnets and other auxiliary equipment.

  19. Spinal fusion - series (image)

    MedlinePlus

    ... muscles hold the graft in place until it fuses with the vertebrae. A fusion will setup within ... hollow threaded titanium or carbon fiber cylinder to fuse two vertebrae together. The diseased disk is removed ...

  20. Magnetized Target Fusion collaboration

    NASA Astrophysics Data System (ADS)

    Intrator, Thomas

    2004-11-01

    Magnetized Target Fusion (MTF) may be a low cost path to fusion, in a regime that is intermediate between magnetic and inertial fusion energy. It requires compression of a magnetized target plasma and consequent heating to fusion relevant conditions inside a converging flux conserver. We hope to demonstrate the physics basis for MTF, with a Field Reversed Configuration (FRC) target plasma to be translated axially to a compression region. We show recent and improved FRC formation data, example deformable liner implosions, and a conceptual design for the upcoming translation experiments, and describe a multi institution collaboration. The FRC is an elongated, compact toroid equilibrium that is extreme among magnetic configurations, and relaxed to a non force free state. There is high plasma beta, small toroidal field, cross-field diamagnetic current and flows, vanishing rotational transform, magnetic shear, helicity and anomalously large resistivity. Scientific issues include MTF with and without FRC's, and fundamental plasma physics beyond MHD, relevant to geophysical and astrophysical phenomena.

  1. Cold nuclear fusion

    SciTech Connect

    Tsyganov, E. N.

    2012-02-15

    Recent accelerator experiments on fusion of various elements have clearly demonstrated that the effective cross-sections of these reactions depend on what material the target particle is placed in. In these experiments, there was a significant increase in the probability of interaction when target nuclei are imbedded in a conducting crystal or are a part of it. These experiments open a new perspective on the problem of so-called cold nuclear fusion.

  2. In vitro and in vivo degradation of bioabsorbable PLLA spinal fusion cages.

    PubMed

    van Dijk, M; Tunc, D C; Smit, T H; Higham, P; Burger, E H; Wuisman, P I J M

    2002-01-01

    The in vitro and in vivo degradation of poly-L-lactic acid cages used as an adjunct to spinal arthrodesis was investigated. In the in vitro experiments cages were subjected to aging up to 73 weeks in phosphate-buffered solution (pH 7.4) at 37 degrees C. Inherent viscosity, crystallinity, and mechanical strength were determined at different time points. In the in vivo study, the poly-L-lactic acid cages were packed with bone graft and implanted in the L3-L4 spinal motion segment of 18 Dutch milk goats. At 12, 26, and 52 weeks, the motion segments were isolated and poly-L-lactic acid samples retrieved. On evaluation, the in vivo implanted cages showed an advanced decline in inherent viscosity compared to the cages subjected to in vitro degradation experiments. At 6 months of implantation, the geometrical shape and original height of 10 mm was maintained during 6 months of follow up. This finding fits well with the observation that mechanical strength was maintained for a period of 6 months in vitro. At 12 months, the poly-L-lactic acid cage had been disintegrated into multiple fragments with signs of absorption. Despite the high-load-bearing conditions, the poly-L-lactic acid cage allowed interbody fusion to occur without collapse of the cage.

  3. ITER Fusion Energy

    ScienceCinema

    Dr. Norbert Holtkamp

    2016-07-12

    ITER (in Latin “the way”) is designed to demonstrate the scientific and technological feasibility of fusion energy. Fusion is the process by which two light atomic nuclei combine to form a heavier over one and thus release energy. In the fusion process two isotopes of hydrogen – deuterium and tritium – fuse together to form a helium atom and a neutron. Thus fusion could provide large scale energy production without greenhouse effects; essentially limitless fuel would be available all over the world. The principal goals of ITER are to generate 500 megawatts of fusion power for periods of 300 to 500 seconds with a fusion power multiplication factor, Q, of at least 10. Q ? 10 (input power 50 MW / output power 500 MW). The ITER Organization was officially established in Cadarache, France, on 24 October 2007. The seven members engaged in the project – China, the European Union, India, Japan, Korea, Russia and the United States – represent more than half the world’s population. The costs for ITER are shared by the seven members. The cost for the construction will be approximately 5.5 billion Euros, a similar amount is foreseen for the twenty-year phase of operation and the subsequent decommissioning.

  4. Magnetized Target Fusion

    NASA Technical Reports Server (NTRS)

    Griffin, Steven T.

    2002-01-01

    Magnetized target fusion (MTF) is under consideration as a means of building a low mass, high specific impulse, and high thrust propulsion system for interplanetary travel. This unique combination is the result of the generation of a high temperature plasma by the nuclear fusion process. This plasma can then be deflected by magnetic fields to provide thrust. Fusion is initiated by a small traction of the energy generated in the magnetic coils due to the plasma's compression of the magnetic field. The power gain from a fusion reaction is such that inefficiencies due to thermal neutrons and coil losses can be overcome. Since the fusion reaction products are directly used for propulsion and the power to initiate the reaction is directly obtained from the thrust generation, no massive power supply for energy conversion is required. The result should be a low engine mass, high specific impulse and high thrust system. The key is to successfully initiate fusion as a proof-of-principle for this application. Currently MSFC is implementing MTF proof-of-principle experiments. This involves many technical details and ancillary investigations. Of these, selected pertinent issues include the properties, orientation and timing of the plasma guns and the convergence and interface development of the "pusher" plasma. Computer simulations of the target plasma's behavior under compression and the convergence and mixing of the gun plasma are under investigation. This work is to focus on the gun characterization and development as it relates to plasma initiation and repeatability.

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

    PubMed Central

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

    2015-01-01

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

  6. Fusion for Space Propulsion

    NASA Technical Reports Server (NTRS)

    Thio, Y. C. Francis; Schafer, Charles (Technical Monitor)

    2001-01-01

    There is little doubt that humans will attempt to explore and develop the solar system in this century. A large amount of energy will be required for accomplishing this. The need for fusion propulsion is discussed. For a propulsion system, there are three important thermodynamical attributes: (1) The absolute amount of energy available, (2) the propellant exhaust velocity, and (3) the jet power per unit mass of the propulsion system (specific power). For human exploration and development of the solar system, propellant exhaust velocity in excess of 100 km/s and specific power in excess of 10 kW/kg are required. Chemical combustion can produce exhaust velocity up to about 5 km/s. Nuclear fission processes typically result in producing energy in the form of heat that needs to be manipulated at temperatures limited by materials to about 2,800 K. Using the energy to heat a hydrogen propellant increases the exhaust velocity by only a factor of about two. Alternatively the energy can be converted into electricity which is then used to accelerate particles to high exhaust velocity. The necessary power conversion and conditioning equipment, however, increases the mass of the propulsion system for the same jet power by more than two orders of magnitude over chemical system, thus greatly limits the thrust-to-weight ratio attainable. The principal advantage of the fission process is that its development is relatively mature and is available right now. If fusion can be developed, fusion appears to have the best of all worlds in terms of propulsion - it can provide the absolute amount, the propellant exhaust velocity, and the high specific jet power. An intermediate step towards pure fusion propulsion is a bimodal system in which a fission reactor is used to provide some of the energy to drive a fusion propulsion unit. The technical issues related to fusion for space propulsion are discussed. The technical priorities for developing and applying fusion for propulsion are

  7. Improvements of image fusion methods

    NASA Astrophysics Data System (ADS)

    Ben-Shoshan, Yotam; Yitzhaky, Yitzhak

    2014-03-01

    Fusion of images from different imaging modalities, obtained by conventional fusion methods, may cause artifacts, including destructive superposition and brightness irregularities, in certain cases. This paper proposes two methods for improving image multimodal fusion quality. Based on the finding that a better fusion can be achieved when the images have a more positive correlation, the first method is a decision algorithm that runs at the preprocessing fusion stage and determines whether a complementary gray level of one of the input images should be used instead of the original one. The second method is suitable for multiresolution fusion, and it suggests choosing only one image from the lowest-frequency sub-bands in the pyramids, instead of combining values from both sub-bands. Experimental results indicate that the proposed fusion enhancement can reduce fusion artifacts. Quantitative fusion quality measures that support this conclusion are shown.

  8. Myoblast fusion in Drosophila

    SciTech Connect

    Haralalka, Shruti; Abmayr, Susan M.

    2010-11-01

    The body wall musculature of a Drosophila larva is composed of an intricate pattern of 30 segmentally repeated muscle fibers in each abdominal hemisegment. Each muscle fiber has unique spatial and behavioral characteristics that include its location, orientation, epidermal attachment, size and pattern of innervation. Many, if not all, of these properties are dictated by founder cells, which determine the muscle pattern and seed the fusion process. Myofibers are then derived from fusion between a specific founder cell and several fusion competent myoblasts (FCMs) fusing with as few as 3-5 FCMs in the small muscles on the most ventral side of the embryo and as many as 30 FCMs in the larger muscles on the dorsal side of the embryo. The focus of the present review is the formation of the larval muscles in the developing embryo, summarizing the major issues and players in this process. We have attempted to emphasize experimentally-validated details of the mechanism of myoblast fusion and distinguish these from the theoretically possible details that have not yet been confirmed experimentally. We also direct the interested reader to other recent reviews that discuss myoblast fusion in Drosophila, each with their own perspective on the process . With apologies, we use gene nomenclature as specified by Flybase (http://flybase.org) but provide Table 1 with alternative names and references.

  9. Fusion, magnetic confinement

    SciTech Connect

    Berk, H.L.

    1992-08-06

    An overview is presented of the principles of magnetic confinement of plasmas for the purpose of achieving controlled fusion conditions. Sec. 1 discusses the different nuclear fusion reactions which can be exploited in prospective fusion reactors and explains why special technologies need to be developed for the supply of tritium or {sup 3}He, the probable fuels. In Sec. 2 the Lawson condition, a criterion that is a measure of the quality of confinement relative to achieving fusion conditions, is explained. In Sec. 3 fluid equations are used to describe plasma confinement. Specific confinement configurations are considered. In Sec. 4 the orbits of particle sin magneti and electric fields are discussed. In Sec. 5 stability considerations are discussed. It is noted that confinement systems usually need to satisfy stability constraints imposed by ideal magnetohydrodynamic (MHD) theory. The paper culminates with a summary of experimental progress in magnetic confinement. Present experiments in tokamaks have reached the point that the conditions necessary to achieve fusion are being satisfied.

  10. Ceramics for fusion applications

    SciTech Connect

    Clinard, F.W. Jr.

    1986-01-01

    Ceramics are required for a variety of uses in both near-term fusion devices and in commercial powerplants. These materials must retain adequate structural and electrical properties under conditions of neutron, particle, and ionizing irradiation; thermal and applied stresses; and physical and chemical sputtering. Ceramics such as Al/sub 2/O/sub 3/, MgAl/sub 2/O/sub 4/, BeO, Si/sub 3/N/sub 4/ and SiC are currently under study for fusion applications, and results to date show widely-varying response to the fusion environment. Materials can be identified today which will meet initial operating requirements, but improvements in physical properties are needed to achieve satisfactory lifetimes for critical applications.

  11. Peaceful Uses of Fusion

    DOE R&D Accomplishments Database

    Teller, E.

    1958-07-03

    Applications of thermonuclear energy for peaceful and constructive purposes are surveyed. Developments and problems in the release and control of fusion energy are reviewed. It is pointed out that the future of thermonuclear power reactors will depend upon the construction of a machine that produces more electric energy than it consumes. The fuel for thermonuclear reactors is cheap and practically inexhaustible. Thermonuclear reactors produce less dangerous radioactive materials than fission reactors and, when once brought under control, are not as likely to be subject to dangerous excursions. The interaction of the hot plasma with magnetic fields opens the way for the direct production of electricity. It is possible that explosive fusion energy released underground may be harnessed for the production of electricity before the same feat is accomplished in controlled fusion processes. Applications of underground detonations of fission devices in mining and for the enhancement of oil flow in large low-specific-yield formations are also suggested.

  12. Simulation of Fusion Plasmas

    ScienceCinema

    Holland, Chris [UC San Diego, San Diego, California, United States

    2016-07-12

    The upcoming ITER experiment (www.iter.org) represents the next major milestone in realizing the promise of using nuclear fusion as a commercial energy source, by moving into the “burning plasma” regime where the dominant heat source is the internal fusion reactions. As part of its support for the ITER mission, the US fusion community is actively developing validated predictive models of the behavior of magnetically confined plasmas. In this talk, I will describe how the plasma community is using the latest high performance computing facilities to develop and refine our models of the nonlinear, multiscale plasma dynamics, and how recent advances in experimental diagnostics are allowing us to directly test and validate these models at an unprecedented level.

  13. Spherical torus fusion reactor

    DOEpatents

    Peng, Yueng-Kay M.

    1989-04-04

    A fusion reactor is provided having a near spherical-shaped plasma with a modest central opening through which straight segments of toroidal field coils extend that carry electrical current for generating a toroidal magnet plasma confinement fields. By retaining only the indispensable components inboard of the plasma torus, principally the cooled toroidal field conductors and in some cases a vacuum containment vessel wall, the fusion reactor features an exceptionally small aspect ratio (typically about 1.5), a naturally elongated plasma cross section without extensive field shaping, requires low strength magnetic containment fields, small size and high beta. These features combine to produce a spherical torus plasma in a unique physics regime which permits compact fusion at low field and modest cost.

  14. Spherical torus fusion reactor

    DOEpatents

    Peng, Yueng-Kay M.

    1989-01-01

    A fusion reactor is provided having a near spherical-shaped plasma with a modest central opening through which straight segments of toroidal field coils extend that carry electrical current for generating a toroidal magnet plasma confinement fields. By retaining only the indispensable components inboard of the plasma torus, principally the cooled toroidal field conductors and in some cases a vacuum containment vessel wall, the fusion reactor features an exceptionally small aspect ratio (typically about 1.5), a naturally elongated plasma cross section without extensive field shaping, requires low strength magnetic containment fields, small size and high beta. These features combine to produce a spherical torus plasma in a unique physics regime which permits compact fusion at low field and modest cost.

  15. CRYOGENICS FOR FUSION

    SciTech Connect

    Dauguet, P.; Bonneton, M.; Fauve, E.; Bernhardt, J. M.; Beauvisage, J.; Andrieu, F.; Gistau-Baguer, G. M.; Boissin, J. C.

    2008-03-16

    Fusion of Hydrogen to produce energy is one of the technologies under study to meet the mankind raising need in energy and as a substitute to fossil fuels for the future. This technology is under investigation for more than 30 years already, with, for example, the former construction of the experimental reactors Tore Supra, DIII-D and JET. With the construction of ITER to start, the next step to 'fusion for energy' will be done. In these projects, an extensive use of cryogenic systems is requested. Air Liquide has been involved as cryogenic partner in most of former and presently constructed fusion reactors. In the present paper, a review of the cryogenic systems we delivered to Tore Supra, JET, IPR and KSTAR will be presented.

  16. Intense fusion neutron sources

    NASA Astrophysics Data System (ADS)

    Kuteev, B. V.; Goncharov, P. R.; Sergeev, V. Yu.; Khripunov, V. I.

    2010-04-01

    The review describes physical principles underlying efficient production of free neutrons, up-to-date possibilities and prospects of creating fission and fusion neutron sources with intensities of 1015-1021 neutrons/s, and schemes of production and application of neutrons in fusion-fission hybrid systems. The physical processes and parameters of high-temperature plasmas are considered at which optimal conditions for producing the largest number of fusion neutrons in systems with magnetic and inertial plasma confinement are achieved. The proposed plasma methods for neutron production are compared with other methods based on fusion reactions in nonplasma media, fission reactions, spallation, and muon catalysis. At present, intense neutron fluxes are mainly used in nanotechnology, biotechnology, material science, and military and fundamental research. In the near future (10-20 years), it will be possible to apply high-power neutron sources in fusion-fission hybrid systems for producing hydrogen, electric power, and technological heat, as well as for manufacturing synthetic nuclear fuel and closing the nuclear fuel cycle. Neutron sources with intensities approaching 1020 neutrons/s may radically change the structure of power industry and considerably influence the fundamental and applied science and innovation technologies. Along with utilizing the energy produced in fusion reactions, the achievement of such high neutron intensities may stimulate wide application of subcritical fast nuclear reactors controlled by neutron sources. Superpower neutron sources will allow one to solve many problems of neutron diagnostics, monitor nano-and biological objects, and carry out radiation testing and modification of volumetric properties of materials at the industrial level. Such sources will considerably (up to 100 times) improve the accuracy of neutron physics experiments and will provide a better understanding of the structure of matter, including that of the neutron itself.

  17. Fusion welding process

    DOEpatents

    Thomas, Kenneth C.; Jones, Eric D.; McBride, Marvin A.

    1983-01-01

    A process for the fusion welding of nickel alloy steel members wherein a ferrite containing pellet is inserted into a cavity in one member and melted by a welding torch. The resulting weld nugget, a fusion of the nickel containing alloy from the members to be welded and the pellet, has a composition which is sufficiently low in nickel content such that ferrite phases occur within the weld nugget, resulting in improved weld properties. The steel alloys encompassed also include alloys containing carbon and manganese, considered nickel equivalents.

  18. Fusion for Space Propulsion

    NASA Technical Reports Server (NTRS)

    Thio, Y. C. Francis; Schmidt, George R.; Santarius, John F.; Turchi, Peter J.; Siemon, Richard E.; Rodgers, Stephen L. (Technical Monitor)

    2002-01-01

    The need for fusion propulsion for interplanetary flights is discussed. For a propulsion system, there are three important system attributes: (1) The absolute amount of energy available, (2) the propellant exhaust velocity, and (3) the jet power per unit mass of the propulsion system (specific power). For efficient and affordable human exploration of the solar system, propellant exhaust velocity in excess of 100 km/s and specific power in excess of 10 kW/kg are required. Chemical combustion obviously cannot meet the requirement in propellant exhaust velocity. Nuclear fission processes typically result in producing energy in the form of heat that needs to be manipulated at temperatures limited by materials to about 2,800 K. Using the fission energy to heat a low atomic weight propellant produces propellant velocity of the order of 10 kinds. Alternatively the fission energy can be converted into electricity that is used to accelerate particles to high exhaust velocity. However, the necessary power conversion and conditioning equipment greatly increases the mass of the propulsion system. Fundamental considerations in waste heat rejection and power conditioning in a fission electric propulsion system place a limit on its jet specific power to the order of about 0.2 kW/kg. If fusion can be developed for propulsion, it appears to have the best of all worlds - it can provide the largest absolute amount of energy, the propellant exhaust velocity (> 100 km/s), and the high specific jet power (> 10 kW/kg). An intermediate step towards fusion propulsion might be a bimodal system in which a fission reactor is used to provide some of the energy to drive a fusion propulsion unit. There are similarities as well as differences between applying fusion to propulsion and to terrestrial electrical power generation. The similarities are the underlying plasma and fusion physics, the enabling component technologies, the computational and the diagnostics capabilities. These physics and

  19. Atomic data for fusion

    SciTech Connect

    Hunter, H.T.; Kirkpatrick, M.I.; Alvarez, I.; Cisneros, C.; Phaneuf, R.A.; Barnett, C.F.

    1990-07-01

    This report provides a handbook of recommended cross-section and rate-coefficient data for inelastic collisions between hydrogen, helium and lithium atoms, molecules and ions, and encompasses more than 400 different reactions of primary interest in fusion research. Published experimental and theoretical data have been collected and evaluated, and the recommended data are presented in tabular, graphical and parametrized form. Processes include excitation and spectral line emission, charge exchange, ionization, stripping, dissociation and particle interchange reactions. The range of collision energies is appropriate to applications in fusion-energy research.

  20. Anterior cervical fusion with a bio-resorbable composite cage (beta TCP-PLLA): clinical and radiological results from a prospective study on 20 patients.

    PubMed

    Debusscher, F; Aunoble, S; Alsawad, Y; Clement, D; Le Huec, Jean-Charles

    2009-09-01

    A resorbable composite material (40% PLLA and 60% beta TCP) with a high breaking strength and capacity to withstand plastic and elastic strain has been developed for cervical interbody fusion. This is a prospective study to evaluate clinical and radiological results of 20 patients implanted with 27 cages (mean follow-up, 27 months). Clinical (neck disability index, VAS, neurological evaluation) and radiological (anteroposterior, lateral, bending X-rays) data were assessed before and after surgery. At the end of the study, CT scan was performed to evaluate fusion, resorption of the cage and density of the new tissue substituting the cage. The mean patient age was 50.3 years (range, 18-79 years). The average improvement was 55% for neck pain, 83% for arm pain and 65% for NDI, with 85% good or excellent results at final outcomes. Radiologically, lordosis was significantly improved (mean gain of 5.4 degrees and 3.7 degrees for overall and segmental lordosis, respectively). This correction was conserved in 95% of cases. Fusion was obtained in 96% (CT evaluation). Resorption was started in all cases and completed in an average of 36 months after surgery. The mean density of tissue substituting the cage was 659 UH with a range, of 455-911 UH (compatible with bone nature). Over time, the amount of bony tissue increased and the graft remodelled with an increase in density value. This demonstrates a biological activity and changing bone mineral content of this tissue. The new composite cage under investigation provides long-term fusion without loss of correction or inflammatory reaction. The ceramic block guarantees the maintenance of the disc height and its slow resorption allows long-term fusion and stability with good and reliable clinical and radiological outcomes. PMID:19533180

  1. Anterior cervical fusion with a bio-resorbable composite cage (beta TCP–PLLA): clinical and radiological results from a prospective study on 20 patients

    PubMed Central

    Debusscher, F.; Aunoble, S.; Alsawad, Y.; Clement, D.

    2009-01-01

    A resorbable composite material (40% PLLA and 60% beta TCP) with a high breaking strength and capacity to withstand plastic and elastic strain has been developed for cervical interbody fusion. This is a prospective study to evaluate clinical and radiological results of 20 patients implanted with 27 cages (mean follow-up, 27 months). Clinical (neck disability index, VAS, neurological evaluation) and radiological (anteroposterior, lateral, bending X-rays) data were assessed before and after surgery. At the end of the study, CT scan was performed to evaluate fusion, resorption of the cage and density of the new tissue substituting the cage. The mean patient age was 50.3 years (range, 18–79 years). The average improvement was 55% for neck pain, 83% for arm pain and 65% for NDI, with 85% good or excellent results at final outcomes. Radiologically, lordosis was significantly improved (mean gain of 5.4° and 3.7° for overall and segmental lordosis, respectively). This correction was conserved in 95% of cases. Fusion was obtained in 96% (CT evaluation). Resorption was started in all cases and completed in an average of 36 months after surgery. The mean density of tissue substituting the cage was 659 UH with a range, of 455–911 UH (compatible with bone nature). Over time, the amount of bony tissue increased and the graft remodelled with an increase in density value. This demonstrates a biological activity and changing bone mineral content of this tissue. The new composite cage under investigation provides long-term fusion without loss of correction or inflammatory reaction. The ceramic block guarantees the maintenance of the disc height and its slow resorption allows long-term fusion and stability with good and reliable clinical and radiological outcomes. PMID:19533180

  2. A polycaprolactone-tricalcium phosphate composite scaffold as an autograft-free spinal fusion cage in a sheep model.

    PubMed

    Li, Yi; Wu, Zhi-gang; Li, Xiao-kang; Guo, Zheng; Wu, Su-hua; Zhang, Yong-quan; Shi, Lei; Teoh, Swee-hin; Liu, Yu-chun; Zhang, Zhi-yong

    2014-07-01

    to increase in tandem with new bone ingrowth into the pores, while maintaining good structural integrity necessary for supporting the spinal interbody segments. Therefore, with the better osteointegration, more bone tissue ingrowth as well as its favorable biodegradable and radiolucent properties, PCL-TCP cage has been demonstrated to be a promising candidate as an autograft-free fusion cage for clinical application.

  3. Multisensor data fusion algorithm development

    SciTech Connect

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

    1995-12-01

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

  4. Fusion engineering device design description

    SciTech Connect

    Flanagan, C.A.; Steiner, D.; Smith, G.E.

    1981-12-01

    The US Magnetic Fusion Engineering Act of 1980 calls for the operation of a Fusion Engineering Device (FED) by 1990. It is the intent of the Act that the FED, in combination with other testing facilities, will establish the engineering feasibility of magnetic fusion energy. During 1981, the Fusion Engineering Design Center (FEDC), under the guidance of a Technical Management Board (TMB), developed a baseline design for the FED. This design is summarized herein.

  5. Fusion Engineering Device design description

    SciTech Connect

    Flanagan, C.A.; Steiner, D.; Smith, G.E.

    1981-12-01

    The US Magnetic Fusion Engineering Act of 1980 calls for the operation of a Fusion Engineering Device (FED) by 1990. It is the intent of the Act that the FED, in combination with other testing facilities, will establish the engineering feasibility of magnetic fusion energy. During 1981, the Fusion Engineering Design Center (FEDC), under the guidance of a Technical Management Board (TMB), developed a baseline design for the FED. This design is summarized herein.

  6. Human-Centered Fusion Framework

    SciTech Connect

    Posse, Christian; White, Amanda M.; Beagley, Nathaniel

    2007-05-16

    In recent years the benefits of fusing signatures extracted from large amounts of distributed and/or heterogeneous data sources have been largely documented in various problems ranging from biological protein function prediction to cyberspace monitoring. In spite of significant progress in information fusion research, there is still no formal theoretical framework for defining various types of information fusion systems, defining and analyzing relations among such types, and designing information fusion systems using a formal method approach. Consequently, fusion systems are often poorly understood, are less than optimal, and/or do not suit user needs. To start addressing these issues, we outline a formal humancentered fusion framework for reasoning about fusion strategies. Our approach relies on a new taxonomy for fusion strategies, an alternative definition of information fusion in terms of parameterized paths in signature related spaces, an algorithmic formalization of fusion strategies and a library of numeric and dynamic visual tools measuring the impact as well as the impact behavior of fusion strategies. Using a real case of intelligence analysis we demonstrate that the proposed framework enables end users to rapidly 1) develop and implement alternative fusion strategies, 2) understand the impact of each strategy, 3) compare the various strategies, and 4) perform the above steps without having to know the mathematical foundations of the framework. We also demonstrate that the human impact on a fusion system is critical in the sense that small changes in strategies do not necessarily correspond to small changes in results.

  7. A fusion of minds

    NASA Astrophysics Data System (ADS)

    Corfield, Richard

    2013-02-01

    Mystery still surrounds the visit of the astronomer Sir Bernard Lovell to the Soviet Union in 1963. But his collaboration - and that of other British scientists - eased geopolitical tensions at the height of the Cold War and paved the way for today's global ITER fusion project, as Richard Corfield explains.

  8. Bubble fusion: Preliminary estimates

    SciTech Connect

    Krakowski, R.A.

    1995-02-01

    The collapse of a gas-filled bubble in disequilibrium (i.e., internal pressure {much_lt} external pressure) can occur with a significant focusing of energy onto the entrapped gas in the form of pressure-volume work and/or acoustical shocks; the resulting heating can be sufficient to cause ionization and the emission of atomic radiations. The suggestion that extreme conditions necessary for thermonuclear fusion to occur may be possible has been examined parametrically in terms of the ratio of initial bubble pressure relative to that required for equilibrium. In this sense, the disequilibrium bubble is viewed as a three-dimensional ``sling shot`` that is ``loaded`` to an extent allowed by the maximum level of disequilibrium that can stably be achieved. Values of this disequilibrium ratio in the range 10{sup {minus}5}--10{sup {minus}6} are predicted by an idealized bubble-dynamics model as necessary to achieve conditions where nuclear fusion of deuterium-tritium might be observed. Harmonic and aharmonic pressurizations/decompressions are examined as means to achieve the required levels of disequilibrium required to create fusion conditions. A number of phenomena not included in the analysis reported herein could enhance or reduce the small levels of nuclear fusions predicted.

  9. Mars manned fusion spaceship

    SciTech Connect

    Hedrick, J.; Buchholtz, B.; Ward, P.; Freuh, J.; Jensen, E.

    1991-01-01

    Fusion Propulsion has an enormous potential for space exploration in the near future. In the twenty-first century, a usable and efficient fusion rocket will be developed and in use. Because of the great distance between other planets and Earth, efficient use of time, fuel, and payload is essential. A nuclear spaceship would provide greater fuel efficiency, less travel time, and a larger payload. Extended missions would give more time for research, experiments, and data acquisition. With the extended mission time, a need for an artificial environment exists. The topics of magnetic fusion propulsion, living modules, artificial gravity, mass distribution, space connection, and orbital transfer to Mars are discussed. The propulsion system is a magnetic fusion reactor based on a tandem mirror design. This allows a faster, shorter trip time and a large thrust to weight ratio. The fuel proposed is a mixture of deuterium and helium. Helium can be obtained from lunar mining. There will be minimal external radiation from the reactor resulting in a safe, efficient propulsion system.

  10. Multilevel fusion exploitation

    NASA Astrophysics Data System (ADS)

    Lindberg, Perry C.; Dasarathy, Belur V.; McCullough, Claire L.

    1996-06-01

    This paper describes a project that was sponsored by the U.S. Army Space and Strategic Defense Command (USASSDC) to develop, test, and demonstrate sensor fusion algorithms for target recognition. The purpose of the project was to exploit the use of sensor fusion at all levels (signal, feature, and decision levels) and all combinations to improve target recognition capability against tactical ballistic missile (TBM) targets. These algorithms were trained with simulated radar signatures to accurately recognize selected TBM targets. The simulated signatures represent measurements made by two radars (S-band and X- band) with the targets at a variety of aspect and roll angles. Two tests were conducted: one with simulated signatures collected at angles different from those in the training database and one using actual test data. The test results demonstrate a high degree of recognition accuracy. This paper describes the training and testing techniques used; shows the fusion strategy employed; and illustrates the advantages of exploiting multi-level fusion.

  11. Mars manned fusion spaceship

    NASA Technical Reports Server (NTRS)

    Hedrick, James; Buchholtz, Brent; Ward, Paul; Freuh, Jim; Jensen, Eric

    1991-01-01

    Fusion Propulsion has an enormous potential for space exploration in the near future. In the twenty-first century, a usable and efficient fusion rocket will be developed and in use. Because of the great distance between other planets and Earth, efficient use of time, fuel, and payload is essential. A nuclear spaceship would provide greater fuel efficiency, less travel time, and a larger payload. Extended missions would give more time for research, experiments, and data acquisition. With the extended mission time, a need for an artificial environment exists. The topics of magnetic fusion propulsion, living modules, artificial gravity, mass distribution, space connection, and orbital transfer to Mars are discussed. The propulsion system is a magnetic fusion reactor based on a tandem mirror design. This allows a faster, shorter trip time and a large thrust to weight ratio. The fuel proposed is a mixture of deuterium and helium-3. Helium-3 can be obtained from lunar mining. There will be minimal external radiation from the reactor resulting in a safe, efficient propulsion system.

  12. Fusion reactor materials

    SciTech Connect

    none,

    1989-01-01

    This paper discuses the following topics on fusion reactor materials: irradiation, facilities, test matrices, and experimental methods; dosimetry, damage parameters, and activation calculations; materials engineering and design requirements; fundamental mechanical behavior; radiation effects; development of structural alloys; solid breeding materials; and ceramics.

  13. Enhanced image capture through fusion

    NASA Technical Reports Server (NTRS)

    Burt, Peter J.; Hanna, Keith; Kolczynski, Raymond J.

    1993-01-01

    Image fusion may be used to combine images from different sensors, such as IR and visible cameras, to obtain a single composite with extended information content. Fusion may also be used to combine multiple images from a given sensor to form a composite image in which information of interest is enhanced. We present a general method for performing image fusion and show that this method is effective for diverse fusion applications. We suggest that fusion may provide a powerful tool for enhanced image capture with broad utility in image processing and computer vision.

  14. Accelerators for heavy ion fusion

    SciTech Connect

    Bangerter, R.O.

    1985-10-01

    Large fusion devices will almost certainly produce net energy. However, a successful commercial fusion energy system must also satisfy important engineering and economic constraints. Inertial confinement fusion power plants driven by multi-stage, heavy-ion accelerators appear capable of meeting these constraints. The reasons behind this promising outlook for heavy-ion fusion are given in this report. This report is based on the transcript of a talk presented at the Symposium on Lasers and Particle Beams for Fusion and Strategic Defense at the University of Rochester on April 17-19, 1985.

  15. In-vitro MRI detectability of interbody test spacers made of carbon fibre-reinforced polymers, titanium and titanium-coated carbon fibre-reinforced polymers.

    PubMed

    Ernstberger, Thorsten; Buchhorn, Gottfried; Baums, Mike Herbert; Heidrich, Gabert

    2007-04-01

    The purpose of this study was to investigate how different materials affect the magnetic resonance imaging (MRI) detectability of interbody test spacers (ITS). We evaluated the post-implantation MRI scans with T1 TSE sequences for three different ITS made of titanium, carbon fibre-reinforced polymers (CFRP) and titanium-coated CFRP, respectively. The main target variables were total artefact volume (TAV) and median artefact area (MAA). Additionally, implant volume (IV)/TAV and cross section (CS)/MAA ratio were determined. The t test and Newman-Keuls test for multiple comparisons were used for statistical analysis. TAV and MAA did not differ significantly between CFRP and titanium-coated CFRP, but were approximately twice as high for the titanium ITS (p < 0.001). MRI detectability was optimum for CFRP and titanium-coated CFRP, but was limited at the implant-bone interface of the titanium ITS. The material's susceptibility and the implant's dimensions affected MRI artefacting. Based on TAV, the volume of titanium surface coating in the ITS studied has no influence on susceptibility in MRI scans with T1 TSE sequences.

  16. The path to fusion power.

    PubMed

    Llewellyn Smith, Chris; Ward, David

    2007-04-15

    Fusion is potentially an environmentally responsible and intrinsically safe source of essentially limitless power. It should be possible to build viable fusion power stations, and it looks as if the cost of fusion power will be reasonable. But time is needed to further develop the technology and to test in power station conditions the materials that would be used in their construction. Assuming no major adverse surprises, an orderly fusion development programme could lead to a prototype fusion power station putting electricity into the grid within 30 years, with commercial fusion power following some 10 or more years later. In the second half of the century, fusion could therefore be an important part of the portfolio of measures that are needed to cope with rising demand for energy in an environmentally responsible manner. In this paper, we describe the basics of fusion, its potential attractions, the status of fusion R&D, the remaining challenges and how they will be tackled at the International Tokamak Experimental Reactor and the proposed International Fusion Materials Irradiation Facility, and the timetable for the subsequent commercialization of fusion power. PMID:17272246

  17. The Need for Fusion Propulsion

    NASA Technical Reports Server (NTRS)

    Cassibry, Jason

    2005-01-01

    Fusion propulsion is inevitable if the human race remains dedicated to exploration of the solar system. There are fundamental reasons why fusion surpasses more traditional approaches to routine crewed missions to Mars, crewed missions to the outer planets, and deep space high speed robotic missions, assuming that reduced trip times, increased payloads, and higher available power are desired. A recent series of informal discussions were held among members from government, academia, and industry concerning fusion propulsion. We compiled a sufficient set of arguments for utilizing fusion in space. If the U.S. is to lead the effort and produce a working system in a reasonable amount of time, NASA must take the initiative, relying on, but not waiting for, DOE guidance. In this talk those arguments for fusion propulsion are presented, along with fusion enabled mission examples, fusion technology trade space, and a proposed outline for future efforts.

  18. Unconventional approaches to fusion

    SciTech Connect

    Brunelli, B.; Leotta, G.G.

    1982-01-01

    This volume is dedicated to unconventional approaches to fusionthose thermonuclear reactors that, in comparison with Tokamak and other main lines, have received little attention in the worldwide scientific community. Many of the approaches considered are still in the embryonic stages. The authors-an international group of active nuclear scientists and engineers-focus on the parameters achieved in the use of these reactors and on the meaning of the most recent physical studies and their implications for the future. They also compare these approaches with conventional ones, the Tokamak in particular, stressing the non-plasma-physics requirements of fusion reactors. Unconventional compact toroids, linear systems, and multipoles are considered, as are the ''almost conventional'' fusion machines: stellarators, mirrors, reversed-field pinches, and EBT.

  19. Fusion Data Grid Service

    NASA Astrophysics Data System (ADS)

    Shasharina, Svetlana; Wang, Nanbor

    2004-11-01

    Simulations and experiments in the fusion and plasma physics community generate large datasets at remote sites. Visualization and analysis of these datasets are difficult because of the incompatibility among the various data formats adopted by simulation, experiments, and analysis tools, and the large sizes of analyzed data. Grids and Web Services technologies are capable of providing solutions for such heterogeneous settings, but need to be customized to the field-specific needs and merged with distributed technologies currently used by the community. This paper describes how we are addressing these issues in the Fusion Grid Service under development. We also present performance results of relevant data transfer mechanisms including binary SOAP, DIME, GridFTP and MDSplus and CORBA. We will describe the status of data converters (between HDF5 and MDSplus data types), developed in collaboration with MIT (J. Stillerman). Finally, we will analyze bottlenecks of MDSplus data transfer mechanism (work performed in collaboration with General Atomics (D. Schissel and M. Qian).

  20. Fusion pumped laser

    DOEpatents

    Pappas, D.S.

    1987-07-31

    The apparatus of this invention may comprise a system for generating laser radiation from a high-energy neutron source. The neutron source is a tokamak fusion reactor generating a long pulse of high-energy neutrons and having a temperature and magnetic field effective to generate a neutron flux of at least 10/sup 15/ neutrons/cm/sup 2//center dot/s. Conversion means are provided adjacent the fusion reactor at a location operable for converting the high-energy neutrons to an energy source with an intensity and energy effective to excite a preselected lasing medium. A lasing medium is spaced about and responsive to the energy source to generate a population inversion effective to support laser oscillations for generating output radiation. 2 figs., 2 tabs.

  1. Experiments in cold fusion

    SciTech Connect

    Palmer, E.P.

    1986-03-28

    The work of Steve Jones and others in muon-catalyzed cold fusion of deuterium and hydrogen suggests the possibility of such fusion catalyzed by ions, or combinations of atoms, or more-or-less free electrons in solid and liquid materials. A hint that this might occur naturally comes from the heat generated in volcanic action in subduction zones on the earth. It is questionable whether the potential energy of material raised to the height of a midocean ridge and falling to the depth of an ocean trench can produce the geothermal effects seen in the volcanoes of subduction zones. If the ridge, the trench, the plates, and the asthenosphere are merely visible effects of deeper density-gradient driven circulations, it is still uncertain that observed energy-concentration effects fit the models.

  2. Modular Aneutronic Fusion Engine

    SciTech Connect

    Gary Pajer, Yosef Razin, Michael Paluszek, A.H. Glasser and Samuel Cohen

    2012-05-11

    NASA's JUNO mission will arrive at Jupiter in July 2016, after nearly five years in space. Since operational costs tend to rise with mission time, minimizing such times becomes a top priority. We present the conceptual design for a 10MW aneutronic fusion engine with high exhaust velocities that would reduce transit time for a Jupiter mission to eighteen months and enable more challenging exploration missions in the solar system and beyond. __________________________________________________

  3. 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.

  4. (Fusion energy research)

    SciTech Connect

    Phillips, C.A.

    1988-01-01

    This report discusses the following topics: principal parameters achieved in experimental devices (FY88); tokamak fusion test reactor; Princeton beta Experiment-Modification; S-1 Spheromak; current drive experiment; x-ray laser studies; spacecraft glow experiment; plasma deposition and etching of thin films; theoretical plasma; tokamak modeling; compact ignition tokamak; international thermonuclear experimental reactor; Engineering Department; Project Planning and Safety Office; quality assurance and reliability; and technology transfer.

  5. Fusion development and technology

    SciTech Connect

    Montgomery, D.B.

    1992-01-01

    This report discusses the following: superconducting magnet technology; high field superconductors; advanced magnetic system and divertor development; poloidal field coils; gyrotron development; commercial reactor studies--aries; ITER physics: alpha physics and alcator R D for ITER; lower hybrid current drive and heating in the ITER device; ITER superconducting PF scenario and magnet analysis; ITER systems studies; and safety, environmental and economic factors in fusion development.

  6. Cold fusion studies

    NASA Astrophysics Data System (ADS)

    Hembree, D. M.; Burchfield, L. A.; Fuller, E. L., Jr.; Perey, F. G.; Mamantov, G.

    1990-06-01

    A series of experiments designed to detect the by-products expected from deuterium fusion occurring in the palladium and titanium cathodes of heavy water, D2O, electrolysis cells is reported. The primary purpose of this account is to outline the integrated experimental design developed to test the cold fusion hypothesis and to report preliminary results that support continuing the investigation. Apparent positive indicators of deuterium fusion were observed, but could not be repeated or proved to originate from the electrochemical cells. In one instance, two large increases in the neutron count rate, the largest of which exceeded the background by 27 standard deviations, were observed. In a separate experiment, one of the calorimetry cells appeared to be producing approximately 18 percent more power that the input value, but thermistor failure prevented an accurate recording of the event as a function of time. In general, the tritium levels in most cells followed the slow enrichment expected from the electrolysis of D2O containing a small amount of tritium. However, after 576 hours of electrolysis, one cell developed a tritium concentration approximately seven times greater than expected level.

  7. [Ultrasound-assisted neuraxial anesthesia in a patient with previous lumbar laminectomy and fusion: a case report].

    PubMed

    Geng, J; Li, M

    2016-02-18

    A patient with previous L3-4 posterior lumbar interbody fusion, pedicle screws instrumentation and L3-4 decompression, was scheduled for left total hip arthroplasty. Two years ago, due to poor landmarks palpation, the patient experienced a failed lumbar puncture after multiple attempts before herniorrhaphy. His plain radiography showed bilateral partial laminectomy at L3-4 level, and between L3 and L4, two posterior pedicle screws connected by metal rods on both sides. This time, we used ultrasound to locate L4-5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture. According to this information, L4-5 puncture point was verified and the combined spinal-epidural anesthesia was performed in a paramedian approach. After withdrawing clear cerebral spinal fluid, 15 mg hyperbaric bupivicaine was injected into intrathecal space. An epidural catheter was then inserted into the epidural space. The sensory block level was fixed at T10 to S within 10 minutes. Intraoperatively, the patient received 10 mL 2% (mass fraction) lidocaine through the epidural catheter in total. The surgery was uneventful. No neurologic complication was observed after the surgery. This case report demonstrates that ultRASound imaging can provide useful information for neuraxial needle placement and can be a valuable tool in managing patients with anatomical change around the spine. PMID:27538165

  8. Sensor fusion for synthetic vision

    NASA Technical Reports Server (NTRS)

    Pavel, M.; Larimer, J.; Ahumada, A.

    1991-01-01

    Display methodologies are explored for fusing images gathered by millimeter wave sensors with images rendered from an on-board terrain data base to facilitate visually guided flight and ground operations in low visibility conditions. An approach to fusion based on multiresolution image representation and processing is described which facilitates fusion of images differing in resolution within and between images. To investigate possible fusion methods, a workstation-based simulation environment is being developed.

  9. Inertial fusion research in China

    NASA Astrophysics Data System (ADS)

    He, X. T.; Zhang, W. Y.

    2007-08-01

    The goal of the first milestone of the inertial fusion program in China is to reach fusion ignition and plasma burning in about 2020. Under the program, in the past years, the inertial fusion physics research achieved great progress; the laser facilities and the support technologies for laser drivers are advanced; the advanced diagnostic techniques are developed and the relatively integrated system is set up; the precise target fabrications are coordinately developed.

  10. Lithium question for nuclear fusion

    SciTech Connect

    Shieh, P.S.S.

    1981-01-01

    An attempt is made to estimate the lithium reserve (the economically recoverable lithium) for the tritium breeding in D-T fusion reactors and other uses. Similar development patterns for fusion energy and fission energy are assumed to estimate the future lithium requirements. These requirements are grouped into three categories; the commercial uses, the lithium batteries for electric cars, and the fusion reactor uses. 5 refs.

  11. 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

  12. 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.

  13. OCULUS Sea Track Fusion Service

    NASA Astrophysics Data System (ADS)

    Panagiotou, Stylianos C.; Rizogiannis, Constantinos; Katsoulis, Stavros; Lampropoulos, Vassilis; Kanellopoulos, Sotirios; Thomopoulos, Stelios C. A.

    2015-06-01

    Oculus Sea is a complete solution regarding maritime surveillance and communications at Local as well as Central Command and Control level. It includes a robust and independent track fusion service whose main functions include: 1) Interaction with the User to suggest the fusion of two or more tracks, confirm Track ID and Vessel Metadata creation for the fused track, and suggest de-association of two tracks 2) Fusion of same vessel tracks arriving simultaneously from multiple radar sensors featuring track Association, track Fusion of associated tracks to produce a more accurate track, and Multiple tracking filters and fusion algorithms 3) Unique Track ID Generator for each fused track 4) Track Dissemination Service. Oculus Sea Track Fusion Service adopts a system architecture where each sensor is associated with a Kalman estimator/tracker that obtains an estimate of the state vector and its respective error covariance matrix. Finally, at the fusion center, association and track state estimation fusion are carried out. The expected benefits of this system include multi-sensor information fusion, enhanced spatial resolution, and improved target detection.

  14. Economic potential of inertial fusion

    SciTech Connect

    Nuckolls, J.H.

    1984-04-01

    Beyond the achievement of scientific feasibility, the key question for fusion energy is: does it have the economic potential to be significantly cheaper than fission and coal energy. If fusion has this high economic potential then there are compelling commercial and geopolitical incentives to accelerate the pace of the fusion program in the near term, and to install a global fusion energy system in the long term. Without this high economic potential, fusion's success depends on the failure of all alternatives, and there is no real incentive to accelerate the program. If my conjectures on the economic potential of inertial fusion are approximately correct, then inertial fusion energy's ultimate costs may be only half to two-thirds those of advanced fission and coal energy systems. Relative cost escalation is not assumed and could increase this advantage. Both magnetic and inertial approaches to fusion potentially have a two-fold economic advantage which derives from two fundamental properties: negligible fuel costs and high quality energy which makes possible more efficient generation of electricity. The wining approach to fusion may excel in three areas: electrical generating efficiency, minimum material costs, and adaptability to manufacture in automated factories. The winning approach must also rate highly in environmental potential, safety, availability factor, lifetime, small 0 and M costs, and no possibility of utility-disabling accidents.

  15. Cold nuclear fusion

    NASA Astrophysics Data System (ADS)

    Tsyganov, E. N.; Bavizhev, M. D.; Buryakov, M. G.; Dabagov, S. B.; Golovatyuk, V. M.; Lobastov, S. P.

    2015-07-01

    If target deuterium atoms were implanted in a metal crystal in accelerator experiments, a sharp increase in the probability of DD-fusion reaction was clearly observed when compared with the reaction's theoretical value. The electronic screening potential, which for a collision of free deuterium atoms is about 27 eV, reached 300-700 eV in the case of the DD-fusion in metallic crystals. These data leads to the conclusion that a ban must exist for deuterium atoms to be in the ground state 1s in a niche filled with free conduction electrons. At the same time, the state 2p whose energy level is only 10 eV above that of state 1s is allowed in these conditions. With anisotropy of 2p, 3p or above orbitals, their spatial positions are strictly determined in the lattice coordinate system. When filling out the same potential niches with two deuterium atoms in the states 2p, 3p or higher, the nuclei of these atoms can be permanently positioned without creating much Coulomb repulsion at a very short distance from each other. In this case, the transparency of the potential barrier increases dramatically compared to the ground state 1s for these atoms. The probability of the deuterium nuclei penetrating the Coulomb barrier by zero quantum vibration of the DD-system also increases dramatically. The so-called cold nuclear DD-fusion for a number of years was registered in many experiments, however, was still rejected by mainstream science for allegedly having no consistent scientific explanation. Finally, it received the validation. Below, we outline the concept of this explanation and give the necessary calculations. This paper also considers the further destiny of the formed intermediate state of 4He∗.

  16. Evaluation of a Hybrid Dynamic Stabilization and Fusion System in the Lumbar Spine: A 10 Year Experience

    PubMed Central

    Kashkoush, Ahmed; Agarwal, Nitin; Paschel, Erin; Goldschmidt, Ezequiel

    2016-01-01

    Introduction: The development of adjacent-segment disease is a recognized consequence of lumbar fusion surgery. Posterior dynamic stabilization, or motion preservation, techniques have been developed which theoretically decrease stress on adjacent segments following fusion. This study presents the experience of using a hybrid dynamic stabilization and fusion construct for degenerative lumbar spine pathology in place of rigid arthrodesis. Methods: A clinical cohort investigation was conducted of 66 consecutive patients (31 female, 35 male; mean age: 53 years, range: 25 – 76 years) who underwent posterior lumbar instrumentation with the Dynesys Transition Optima (DTO) implant (Zimmer-Biomet Spine, Warsaw, IN) hybrid dynamic stabilization and fusion system over a 10-year period. The median length of follow-up was five years. DTO consists of pedicle screw fixation coupled to a rigid rod as well as a flexible longitudinal connecting system. All patients had symptoms of back pain and neurogenic claudication refractory to non-surgical treatment. Patients underwent lumbar arthrodesis surgery in which the hybrid system was used for stabilization instead of arthrodesis of the stenotic adjacent level. Results: Indications for DTO instrumentation were primary degenerative disc disease (n = 52) and failed back surgery syndrome (n = 14). The most common dynamically stabilized and fused segments were L3-L4 (n = 37) and L5-S1 (n = 33), respectively. Thirty-eight patients (56%) underwent decompression at the dynamically stabilized level, and 57 patients (86%) had an interbody device placed at the level of arthrodesis. Complications during the follow-up period included a single case of screw breakage and a single case of pseudoarthrosis. Ten patients (15%) subsequently underwent conversion of the dynamic stabilization portion of their DTO instrumentation to rigid spinal arthrodesis. Conclusion: The DTO system represents a novel hybrid dynamic stabilization and fusion construct

  17. Fusion reactor pumped laser

    DOEpatents

    Jassby, Daniel L.

    1988-01-01

    A nuclear pumped laser capable of producing long pulses of very high power laser radiation is provided. A toroidal fusion reactor provides energetic neutrons which are slowed down by a moderator. The moderated neutrons are converted to energetic particles capable of pumping a lasing medium. The lasing medium is housed in an annular cell surrounding the reactor. The cell includes an annular reflecting mirror at the bottom and an annular output window at the top. A neutron reflector is disposed around the cell to reflect escaping neutrons back into the cell. The laser radiation from the annular window is focused onto a beam compactor which generates a single coherent output laser beam.

  18. 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.

  19. Magnetless magnetic fusion

    NASA Astrophysics Data System (ADS)

    Beklemishev, A. D.; Tajima, T.

    1994-02-01

    The authors propose a concept of thermonuclear fusion reactor in which the plasma pressure is balanced by direct gas-wall interaction in a high-pressure vessel. The energy confinement is achieved by means of the self-contained toroidal magnetic configuration sustained by an external current drive or charged fusion products. This field structure causes the plasma pressure to decrease toward the inside of the discharge and thus it should be magnetohydrodynamically stable. The maximum size, temperature and density profiles of the reactor are estimated. An important feature of confinement physics is the thin layer of cold gas at the wall and the adjacent transitional region of dense arc-like plasma. The burning condition is determined by the balance between these nonmagnetized layers and the current-carrying plasma. They suggest several questions for future investigation, such as the thermal stability of the transition layer and the possibility of an effective heating and current drive behind the dense edge plasma. The main advantage of this scheme is the absence of strong external magnets and, consequently, potentially cheaper design and lower energy consumption.

  20. Multispectral bilateral video fusion.

    PubMed

    Bennett, Eric P; Mason, John L; McMillan, Leonard

    2007-05-01

    We present a technique for enhancing underexposed visible-spectrum video by fusing it with simultaneously captured video from sensors in nonvisible spectra, such as Short Wave IR or Near IR. Although IR sensors can accurately capture video in low-light and night-vision applications, they lack the color and relative luminances of visible-spectrum sensors. RGB sensors do capture color and correct relative luminances, but are underexposed, noisy, and lack fine features due to short video exposure times. Our enhanced fusion output is a reconstruction of the RGB input assisted by the IR data, not an incorporation of elements imaged only in IR. With a temporal noise reduction, we first remove shot noise and increase the color accuracy of the RGB footage. The IR video is then normalized to ensure cross-spectral compatibility with the visible-spectrum video using ratio images. To aid fusion, we decompose the video sources with edge-preserving filters. We introduce a multispectral version of the bilateral filter called the "dual bilateral" that robustly decomposes the RGB video. It utilizes the less-noisy IR for edge detection but also preserves strong visible-spectrum edges not in the IR. We fuse the RGB low frequencies, the IR texture details, and the dual bilateral edges into a noise-reduced video with sharp details, correct chrominances, and natural relative luminances. PMID:17491451

  1. Inertial confinement fusion

    SciTech Connect

    Powers, L.; Condouris, R.; Kotowski, M.; Murphy, P.W.

    1992-01-01

    This issue of the ICF Quarterly contains seven articles that describe recent progress in Lawrence Livermore National Laboratory's ICF program. The Department of Energy recently initiated an effort to design a 1--2 MJ glass laser, the proposed National Ignition Facility (NIF). These articles span various aspects of a program which is aimed at moving forward toward such a facility by continuing to use the Nova laser to gain understanding of NIF-relevant target physics, by developing concepts for an NIF laser driver, and by envisioning a variety of applications for larger ICF facilities. This report discusses research on the following topics: Stimulated Rotational Raman Scattering in Nitrogen; A Maxwell Equation Solver in LASNEX for the Simulation of Moderately Intense Ultrashort Pulse Experiments; Measurements of Radial Heat-Wave Propagation in Laser-Produced Plasmas; Laser-Seeded Modulation Growth on Directly Driven Foils; Stimulated Raman Scattering in Large-Aperture, High-Fluence Frequency-Conversion Crystals; Fission Product Hazard Reduction Using Inertial Fusion Energy; Use of Inertial Confinement Fusion for Nuclear Weapons Effects Simulations.

  2. Helium Find Thaws the Cold Fusion Trail.

    ERIC Educational Resources Information Center

    Pennisi, E.

    1991-01-01

    Reported is a study of cold fusion in which trace amounts of helium, possible evidence of an actual fusion reaction, were found. Research methodology is detailed. The controversy over the validity of experimental results with cold fusion are reviewed. (CW)

  3. Multi-sensor fusion development

    NASA Astrophysics Data System (ADS)

    Bish, Sheldon; Rohrer, Matthew; Scheffel, Peter; Bennett, Kelly

    2016-05-01

    The U.S. Army Research Laboratory (ARL) and McQ Inc. are developing a generic sensor fusion architecture that involves several diverse processes working in combination to create a dynamic task-oriented, real-time informational capability. Processes include sensor data collection, persistent and observational data storage, and multimodal and multisensor fusion that includes the flexibility to modify the fusion program rules for each mission. Such a fusion engine lends itself to a diverse set of sensing applications and architectures while using open-source software technologies. In this paper, we describe a fusion engine architecture that combines multimodal and multi-sensor fusion within an Open Standard for Unattended Sensors (OSUS) framework. The modular, plug-and-play architecture of OSUS allows future fusion plugin methodologies to have seamless integration into the fusion architecture at the conceptual and implementation level. Although beyond the scope of this paper, this architecture allows for data and information manipulation and filtering for an array of applications.

  4. The status of cold fusion

    NASA Astrophysics Data System (ADS)

    Storms, E.

    This report attempts to update the status of the phenomenon of cold fusion. The new field is continuing to grow as a variety of nuclear reactions are discovered to occur in a variety of chemical environments at modest temperatures. However, it must be cautioned that most scientists consider cold fusion as something akin to UFO's, ESP, and numerology.

  5. Data fusion qualitative sensitivity analysis

    SciTech Connect

    Clayton, E.A.; Lewis, R.E.

    1995-09-01

    Pacific Northwest Laboratory was tasked with testing, debugging, and refining the Hanford Site data fusion workstation (DFW), with the assistance of Coleman Research Corporation (CRC), before delivering the DFW to the environmental restoration client at the Hanford Site. Data fusion is the mathematical combination (or fusion) of disparate data sets into a single interpretation. The data fusion software used in this study was developed by CRC. The data fusion software developed by CRC was initially demonstrated on a data set collected at the Hanford Site where three types of data were combined. These data were (1) seismic reflection, (2) seismic refraction, and (3) depth to geologic horizons. The fused results included a contour map of the top of a low-permeability horizon. This report discusses the results of a sensitivity analysis of data fusion software to variations in its input parameters. The data fusion software developed by CRC has a large number of input parameters that can be varied by the user and that influence the results of data fusion. Many of these parameters are defined as part of the earth model. The earth model is a series of 3-dimensional polynomials with horizontal spatial coordinates as the independent variables and either subsurface layer depth or values of various properties within these layers (e.g., compression wave velocity, resistivity) as the dependent variables.

  6. The quest for fusion power

    NASA Astrophysics Data System (ADS)

    Cowley, Steven C.

    2016-05-01

    Fusion power is one of a very few sustainable options to replace fossil fuels as the world's primary energy source. Although the conditions for fusion have been reached, much remains to be done to turn scientific success into commercial electrical power.

  7. 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.

  8. 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.

  9. Cold fusion; Myth versus reality

    SciTech Connect

    Rabinowitz, M. )

    1990-01-01

    Experiments indicate that several different nuclear reactions are taking place. Some of the experiments point to D-D fusion with a cominant tritium channel as one of the reactions. The article notes a similarity between Prometheus and the discoveries of cold fusion.

  10. Deployment of membrane fusion protein domains during fusion.

    PubMed

    Bentz, J; Mittal, A

    2000-01-01

    It is clear that both viral and intracellular membrane fusion proteins contain a minimal set of domains which must be deployed at the appropriate time during the fusion process. An account of these domains and their functions is given here for the four best-described fusion systems: influenza HA, sendai virus F1, HIV gp120/41 and the neuronal SNARE core composed of synaptobrevin (syn), syntaxin (stx) and the N- and C-termini of SNAP25 (sn25), together with the Ca(2+)binding protein synaptotagmin (syt). Membrane fusion begins with the binding of the virion or vesicle to the target membrane via receptors. The committed step in influenza HA- mediated fusion begins with an aggregate of HAs (at least eight) with some of their HA2 N-termini, a.k.a. fusion peptides, embedded into the viral bilayer (Bentz, 2000 a). The hypothesis presented in Bentz (2000 b) is that the conformational change of HA to the extended coiled coil extracts the fusion peptides from the viral bilayer. When this extraction occurs from the center of the site of restricted lipid flow, it exposes acyl chains and parts of the HA transmembrane domains to the aqueous media, i.e. a hydrophobic defect is formed. This is the 'transition state' of the committed step of fusion. It is stabilized by a 'dam' of HAs, which are inhibited from diffusing away by the rest of the HAs in the aggregate and because that would initially expose more acyl chains to water. Recruitment of lipids from the apposed target membrane can heal this hydrophobic defect, initiating lipid mixing and fusion. The HA transmembrane domains are required to be part of the hydrophobic defect, because the HA aggregate must be closely packed enough to restrict lipid flow. This hypothesis provides a simple and direct coupling between the energy released by the formation of the coiled coil to the energy needed to create and stabilize the high energy intermediates of fusion. Several of these essential domains have been described for the viral fusion

  11. Adjoint affine fusion and tadpoles

    NASA Astrophysics Data System (ADS)

    Urichuk, Andrew; Walton, Mark A.

    2016-06-01

    We study affine fusion with the adjoint representation. For simple Lie algebras, elementary and universal formulas determine the decomposition of a tensor product of an integrable highest-weight representation with the adjoint representation. Using the (refined) affine depth rule, we prove that equally striking results apply to adjoint affine fusion. For diagonal fusion, a coefficient equals the number of nonzero Dynkin labels of the relevant affine highest weight, minus 1. A nice lattice-polytope interpretation follows and allows the straightforward calculation of the genus-1 1-point adjoint Verlinde dimension, the adjoint affine fusion tadpole. Explicit formulas, (piecewise) polynomial in the level, are written for the adjoint tadpoles of all classical Lie algebras. We show that off-diagonal adjoint affine fusion is obtained from the corresponding tensor product by simply dropping non-dominant representations.

  12. Is there hope for fusion

    SciTech Connect

    Fowler, T.K. . Dept. of Nuclear Engineering)

    1990-04-12

    From the outset in the 1950's, fusion research has been motivated by environmental concerns as well as long-term fuel supply issues. Compared to fossil fuels both fusion and fission would produce essentially zero emissions to the atmosphere. Compared to fission, fusion reactors should offer high demonstrability of public protection from accidents and a substantial amelioration of the radioactive waste problem. Fusion still requires lengthy development, the earliest commercial deployment being likely to occur around 2025--2050. However, steady scientific progress is being made and there is a wide consensus that it is time to plan large-scale engineering development. A major international effort, called the International Thermonuclear Experimental Reactor (ITER), is being carried out under IAEA auspices to design the world's first fusion engineering test reactor, which could be constructed in the 1990's. 4 figs., 3 tabs.

  13. Magnetic fusion energy and computers

    SciTech Connect

    Killeen, J.

    1982-01-01

    The application of computers to magnetic fusion energy research is essential. In the last several years the use of computers in the numerical modeling of fusion systems has increased substantially. There are several categories of computer models used to study the physics of magnetically confined plasmas. A comparable number of types of models for engineering studies are also in use. To meet the needs of the fusion program, the National Magnetic Fusion Energy Computer Center has been established at the Lawrence Livermore National Laboratory. A large central computing facility is linked to smaller computer centers at each of the major MFE laboratories by a communication network. In addition to providing cost effective computing services, the NMFECC environment stimulates collaboration and the sharing of computer codes among the various fusion research groups.

  14. Information integration for data fusion

    SciTech Connect

    Bray, O.H.

    1997-01-01

    Data fusion has been identified by the Department of Defense as a critical technology for the U.S. defense industry. Data fusion requires combining expertise in two areas - sensors and information integration. Although data fusion is a rapidly growing area, there is little synergy and use of common, reusable, and/or tailorable objects and models, especially across different disciplines. The Laboratory-Directed Research and Development project had two purposes: to see if a natural language-based information modeling methodology could be used for data fusion problems, and if so, to determine whether this methodology would help identify commonalities across areas and achieve greater synergy. The project confirmed both of the initial hypotheses: that the natural language-based information modeling methodology could be used effectively in data fusion areas and that commonalities could be found that would allow synergy across various data fusion areas. The project found five common objects that are the basis for all of the data fusion areas examined: targets, behaviors, environments, signatures, and sensors. Many of the objects and the specific facts related to these objects were common across several areas and could easily be reused. In some cases, even the terminology remained the same. In other cases, different areas had their own terminology, but the concepts were the same. This commonality is important with the growing use of multisensor data fusion. Data fusion is much more difficult if each type of sensor uses its own objects and models rather than building on a common set. This report introduces data fusion, discusses how the synergy generated by this LDRD would have benefited an earlier successful project and contains a summary information model from that project, describes a preliminary management information model, and explains how information integration can facilitate cross-treaty synergy for various arms control treaties.

  15. Multiple shell fusion targets

    DOEpatents

    Lindl, J.D.; Bangerter, R.O.

    1975-10-31

    Multiple shell fusion targets for use with electron beam and ion beam implosion systems are described. The multiple shell targets are of the low-power type and use a separate relatively low Z, low density ablator at large radius for the outer shell, which reduces the focusing and power requirements of the implosion system while maintaining reasonable aspect ratios. The targets use a high Z, high density pusher shell placed at a much smaller radius in order to obtain an aspect ratio small enough to protect against fluid instability. Velocity multiplication between these shells further lowers the power requirements. Careful tuning of the power profile and intershell density results in a low entropy implosion which allows breakeven at low powers. For example, with ion beams as a power source, breakeven at 10-20 Terrawatts with 10 MeV alpha particles for imploding a multiple shell target can be accomplished.

  16. Fusion pumped laser

    DOEpatents

    Pappas, Daniel S.

    1989-01-01

    Apparatus is provided for generating energy in the form of laser radiation. A tokamak fusion reactor is provided for generating a long, or continuous, pulse of high-energy neutrons. The tokamak design provides a temperature and a magnetic field which is effective to generate a neutron flux of at least 10.sup.15 neutrons/cm.sup.2.s. A conversion medium receives neutrons from the tokamak and converts the high-energy neutrons to an energy source with an intensity and an energy effective to excite a preselected lasing medium. The energy source typically comprises fission fragments, alpha particles, and radiation from a fission event. A lasing medium is provided which is responsive to the energy source to generate a population inversion which is effective to support laser oscillations for generating output radiation.

  17. Fusion reactor pumped laser

    DOEpatents

    Jassby, D.L.

    1987-09-04

    A nuclear pumped laser capable of producing long pulses of very high power laser radiation is provided. A toroidal fusion reactor provides energetic neutrons which are slowed down by a moderator. The moderated neutrons are converted to energetic particles capable of pumping a lasing medium. The lasing medium is housed in an annular cell surrounding the reactor. The cell includes an annular reflecting mirror at the bottom and an annular output window at the top. A neutron reflector is disposed around the cell to reflect escaping neutrons back into the cell. The laser radiation from the annular window is focused onto a beam compactor which generates a single coherent output laser beam. 10 figs.

  18. Fusion pumped light source

    DOEpatents

    Pappas, Daniel S.

    1989-01-01

    Apparatus is provided for generating energy in the form of light radiation. A fusion reactor is provided for generating a long, or continuous, pulse of high-energy neutrons. The neutron flux is coupled directly with the lasing medium. The lasing medium includes a first component selected from Group O of the periodic table of the elements and having a high inelastic scattering cross section. Gamma radiation from the inelastic scattering reactions interacts with the first component to excite the first component, which decays by photon emission at a first output wavelength. The first output wavelength may be shifted to a second output wavelength using a second liquid component responsive to the first output wavelength. The light outputs may be converted to a coherent laser output by incorporating conventional optics adjacent the laser medium.

  19. LiWall Fusion - The New Concept of Magnetic Fusion

    SciTech Connect

    L.E. Zakharov

    2011-01-12

    Utilization of the outstanding abilities of a liquid lithium layer in pumping hydrogen isotopes leads to a new approach to magnetic fusion, called the LiWall Fusion. It relies on innovative plasma regimes with low edge density and high temperature. The approach combines fueling the plasma by neutral injection beams with the best possible elimination of outside neutral gas sources, which cools down the plasma edge. Prevention of cooling the plasma edge suppresses the dominant, temperature gradient related turbulence in the core. Such an approach is much more suitable for controlled fusion than the present practice, relying on high heating power for compensating essentially unlimited turbulent energy losses.

  20. Porous titanium-6 aluminum-4 vanadium cage has better osseointegration and less micromotion than a poly-ether-ether-ketone cage in sheep vertebral fusion.

    PubMed

    Wu, Su-Hua; Li, Yi; Zhang, Yong-Quan; Li, Xiao-Kang; Yuan, Chao-Fan; Hao, Yu-Lin; Zhang, Zhi-Yong; Guo, Zheng

    2013-12-01

    Interbody fusion cages made of poly-ether-ether-ketone (PEEK) have been widely used in clinics for spinal disorders treatment; however, they do not integrate well with surrounding bone tissue. Ti-6Al-4V (Ti) has demonstrated greater osteoconductivity than PEEK, but the traditional Ti cage is generally limited by its much greater elastic modulus (110 GPa) than natural bone (0.05-30 GPa). In this study, we developed a porous Ti cage using electron beam melting (EBM) technique to reduce its elastic modulus and compared its spinal fusion efficacy with a PEEK cage in a preclinical sheep anterior cervical fusion model. A porous Ti cage possesses a fully interconnected porous structure (porosity: 68 ± 5.3%; pore size: 710 ± 42 μm) and a similar Young's modulus as natural bone (2.5 ± 0.2 GPa). When implanted in vivo, the porous Ti cage promoted fast bone ingrowth, achieving similar bone volume fraction at 6 months as the PEEK cage without autograft transplantation. Moreover, it promoted better osteointegration with higher degree (2-10x) of bone-material binding, demonstrated by histomorphometrical analysis, and significantly higher mechanical stability (P < 0.01), shown by biomechanical testing. The porous Ti cage fabricated by EBM could achieve fast bone ingrowth. In addition, it had better osseointegration and superior mechanical stability than the conventional PEEK cage, demonstrating great potential for clinical application.

  1. Soldier systems sensor fusion

    NASA Astrophysics Data System (ADS)

    Brubaker, Kathryne M.

    1998-08-01

    This paper addresses sensor fusion and its applications in emerging Soldier Systems integration and the unique challenges associated with the human platform. Technology that,provides the highest operational payoff in a lightweight warrior system must not only have enhanced capabilities, but have low power components resulting in order of magnitude reductions coupled with significant cost reductions. These reductions in power and cost will be achieved through partnership with industry and leveraging of commercial state of the art advancements in microelectronics and power sources. As new generation of full solution fire control systems (to include temperature, wind and range sensors) and target acquisition systems will accompany a new generation of individual combat weapons and upgrade existing weapon systems. Advanced lightweight thermal, IR, laser and video senors will be used for surveillance, target acquisition, imaging and combat identification applications. Multifunctional sensors will provide embedded training features in combat configurations allowing the soldier to 'train as he fights' without the traditional cost and weight penalties associated with separate systems. Personal status monitors (detecting pulse, respiration rate, muscle fatigue, core temperature, etc.) will provide commanders and highest echelons instantaneous medical data. Seamless integration of GPS and dead reckoning (compass and pedometer) and/or inertial sensors will aid navigation and increase position accuracy. Improved sensors and processing capability will provide earlier detection of battlefield hazards such as mines, enemy lasers and NBC (nuclear, biological, chemical) agents. Via the digitized network the situational awareness database will automatically be updated with weapon, medical, position and battlefield hazard data. Soldier Systems Sensor Fusion will ultimately establish each individual soldier as an individual sensor on the battlefield.

  2. Prospects for bubble fusion

    SciTech Connect

    Nigmatulin, R.I.; Lahey, R.T. Jr.

    1995-09-01

    In this paper a new method for the realization of fusion energy is presented. This method is based on the superhigh compression of a gas bubble (deuterium or deuterium/thritium) in heavy water or another liquid. The superhigh compression of a gas bubble in a liquid is achieved through forced non-linear, non-periodic resonance oscillations using moderate amplitudes of forcing pressure. The key feature of this new method is a coordination of the forced liquid pressure change with the change of bubble volume. The corresponding regime of the bubble oscillation has been called {open_quotes}basketball dribbling (BD) regime{close_quotes}. The analytical solution describing this process for spherically symmetric bubble oscillations, neglecting dissipation and compressibility of the liquid, has been obtained. This solution shown no limitation on the supercompression of the bubble and the corresponding maximum temperature. The various dissipation mechanisms, including viscous, conductive and radiation heat losses have been considered. It is shown that in spite of these losses it is possible to achieve very high gas bubble temperatures. This because the time duration of the gas bubble supercompression becomes very short when increasing the intensity of compression, thus limiting the energy losses. Significantly, the calculated maximum gas temperatures have shown that nuclear fusion may be possible. First estimations of the affect of liquid compressibility have been made to determine possible limitations on gas bubble compression. The next step will be to investigate the role of interfacial instability and breaking down of the bubble, shock wave phenomena around and in the bubble and mutual diffusion of the gas and the liquid.

  3. Fission-fusion neutron source

    NASA Astrophysics Data System (ADS)

    Yu, Jinnan; Yu, Gang

    2009-04-01

    In order to meet the requirements of fusion power reactors and nuclear waste treatment, a concept of fission-fusion neutron source is proposed, which consists of a LiD assembly located in the heavy water region of the China Advanced Research Reactor. This assembly of LiD fuel rods will be irradiated with slow neutrons and will produce fusion neutrons in the central hole via the reaction 6Li(n, α). More precisely, tritium ions with a high energy of 2.739 MeV will be produced in LiD by the impinging slow neutrons. The tritium ions will in turn bombard the deuterium ions present in the LiD assembly, which will induce fusion reaction and then the production of 14 MeV neutrons. The fusion reaction rate will increase with the accumulation of tritium in LiD by the reaction between tritium and deuteron recoils produced by the 14 MeV neutrons. When the concentration of tritium reaches 0.5 · 10 22 and the fraction of fusion reactions between tritium and deuteron recoils approaches 1, the 14 MeV neutron flux is doubled and redoubled, an so forth, approaching saturation in which the tritium produced at a time t is exhausted by the fusion reactions to keep constant the tritium concentration in LiD.

  4. Future of Inertial Fusion Energy

    SciTech Connect

    Nuckolls, J H; Wood, L L

    2002-09-04

    In the past 50 years, fusion R&D programs have made enormous technical progress. Projected billion-dollar scale research facilities are designed to approach net energy production. In this century, scientific and engineering progress must continue until the economics of fusion power plants improves sufficiently to win large scale private funding in competition with fission and non-nuclear energy systems. This economic advantage must be sustained: trillion dollar investments will be required to build enough fusion power plants to generate ten percent of the world's energy. For Inertial Fusion Energy, multi-billion dollar driver costs must be reduced by up to an order of magnitude, to a small fraction of the total cost of the power plant. Major cost reductions could be achieved via substantial improvements in target performance-both higher gain and reduced ignition energy. Large target performance improvements may be feasible through a combination of design innovations, e.g., ''fast ignition,'' propagation down density gradients, and compression of fusion fuel with a combination of driver and chemical energy. The assumptions that limit projected performance of fusion targets should be carefully examined. The National Ignition Facility will enable development and testing of revolutionary targets designed to make possible economically competitive fusion power plants.

  5. Poxvirus entry and membrane fusion

    SciTech Connect

    Moss, Bernard . E-mail: bmoss@nih.gov

    2006-01-05

    The study of poxvirus entry and membrane fusion has been invigorated by new biochemical and microscopic findings that lead to the following conclusions: (1) the surface of the mature virion (MV), whether isolated from an infected cell or by disruption of the membrane wrapper of an extracellular virion, is comprised of a single lipid membrane embedded with non-glycosylated viral proteins; (2) the MV membrane fuses with the cell membrane, allowing the core to enter the cytoplasm and initiate gene expression; (3) fusion is mediated by a newly recognized group of viral protein components of the MV membrane, which are conserved in all members of the poxvirus family; (4) the latter MV entry/fusion proteins are required for cell to cell spread necessitating the disruption of the membrane wrapper of extracellular virions prior to fusion; and furthermore (5) the same group of MV entry/fusion proteins are required for virus-induced cell-cell fusion. Future research priorities include delineation of the roles of individual entry/fusion proteins and identification of cell receptors.

  6. Control of mechanically activated polymersome fusion: Factors affecting fusion

    SciTech Connect

    Henderson, Ian M.; Paxton, Walter F.

    2014-12-15

    Previously we have studied the mechanically-activated fusion of extruded (200 nm) polymer vesicles into giant polymersomes using agitation in the presence of salt. In this study we have investigated several factors contributing to this phenomenon, including the effects of (i) polymer vesicle concentration, (ii) agitation speed and duration, and iii) variation of the salt and its concentration. It was found that increasing the concentration of the polymer dramatically increases the production of giant vesicles through the increased collisions of polymersomes. Our investigations also found that increasing the frequency of agitation increased the efficiency of fusion, though ultimately limited the size of vesicle which could be produced due to the high shear involved. Finally it was determined that salt-mediation of the fusion process was not limited to NaCl, but is instead a general effect facilitated by the presence of solvated ionic compounds, albeit with different salts initiating fusion at different concentration.

  7. Control of mechanically activated polymersome fusion: Factors affecting fusion

    DOE PAGESBeta

    Henderson, Ian M.; Paxton, Walter F.

    2014-12-15

    Previously we have studied the mechanically-activated fusion of extruded (200 nm) polymer vesicles into giant polymersomes using agitation in the presence of salt. In this study we have investigated several factors contributing to this phenomenon, including the effects of (i) polymer vesicle concentration, (ii) agitation speed and duration, and iii) variation of the salt and its concentration. It was found that increasing the concentration of the polymer dramatically increases the production of giant vesicles through the increased collisions of polymersomes. Our investigations also found that increasing the frequency of agitation increased the efficiency of fusion, though ultimately limited the sizemore » of vesicle which could be produced due to the high shear involved. Finally it was determined that salt-mediation of the fusion process was not limited to NaCl, but is instead a general effect facilitated by the presence of solvated ionic compounds, albeit with different salts initiating fusion at different concentration.« less

  8. Pubertal growth and epiphyseal fusion

    PubMed Central

    2015-01-01

    The complex networks of nutritional, cellular, paracrine, and endocrine factors are closely related with pubertal growth and epiphyseal fusion. Important influencing factors include chondrocyte differentiation capacity, multiple molecular pathways active in the growth plate, and growth hormone-insulin-like growth factor-I axis activation and epiphyseal fusion through estrogen and its receptors. However, the exact mechanisms of these phenomena are still unclear. A better understanding of the detailed processes involved in the pubertal growth spurt and growth plate closure in longitudinal bone growth will help us develop methods to efficiently promote pubertal growth and delay epiphyseal fusion with fewer adverse effects. PMID:25883921

  9. The path to fusion power†

    PubMed Central

    Smith, Chris Llewellyn; Cowley, Steve

    2010-01-01

    The promise, status and challenges of developing fusion power are outlined. The key physics and engineering principles are described and recent progress quantified. As the successful demonstration of 16 MW of fusion in 1997 in the Joint European Torus showed, fusion works. The central issue is therefore to make it work reliably and economically on the scale of a power station. We argue that to meet this challenge in 30 years we must follow the aggressive programme known as the ‘Fast Track to Fusion’. This programme is described in some detail. PMID:20123748

  10. Advanced fusion concepts: project summaries

    SciTech Connect

    1980-12-01

    This report contains descriptions of the activities of all the projects supported by the Advanced Fusion Concepts Branch of the Office of Fusion Energy, US Department of Energy. These descriptions are project summaries of each of the individual projects, and contain the following: title, principle investigators, funding levels, purpose, approach, progress, plans, milestones, graduate students, graduates, other professional staff, and recent publications. Information is given for each of the following programs: (1) reverse-field pinch, (2) compact toroid, (3) alternate fuel/multipoles, (4) stellarator/torsatron, (5) linear magnetic fusion, (6) liners, and (7) Tormac. (MOW)

  11. Fusion materials irradiations at MaRIE's fission fusion facility

    SciTech Connect

    Pitcher, Eric J

    2010-10-06

    Los Alamos National Laboratory's proposed signature facility, MaRIE, will provide scientists and engineers with new capabilities for modeling, synthesizing, examining, and testing materials of the future that will enhance the USA's energy security and national security. In the area of fusion power, the development of new structural alloys with better tolerance to the harsh radiation environments expected in fusion reactors will lead to improved safety and lower operating costs. The Fission and Fusion Materials Facility (F{sup 3}), one of three pillars of the proposed MaRIE facility, will offer researchers unprecedented access to a neutron radiation environment so that the effects of radiation damage on materials can be measured in-situ, during irradiation. The calculated radiation damage conditions within the F{sup 3} match, in many respects, that of a fusion reactor first wall, making it well suited for testing fusion materials. Here we report in particular on two important characteristics of the radiation environment with relevancy to radiation damage: the primary knock-on atom spectrum and the impact of the pulse structure of the proton beam on temporal characteristics of the atomic displacement rate. With respect to both of these, analyses show the F{sup 3} has conditions that are consistent with those of a steady-state fusion reactor first wall.

  12. 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. PMID:26040699

  13. 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

  14. Prospects for fusion: The winds of change

    NASA Astrophysics Data System (ADS)

    Davidson, R. C.

    This paper addresses the following topics: (1) national energy circumstances and policy, and the implications for fusion; (2) the intrinsic merit of fusion research and development as it contributes to the national science and technology base; (3) the research opportunities and priorities in inertial confinement fusion; and (4) the research opportunities and priorities in magnetic fusion.

  15. Condensed hydrogen for thermonuclear fusion

    SciTech Connect

    Kucheyev, S. O.; Hamza, A. V.

    2010-11-15

    Inertial confinement fusion (ICF) power, in either pure fusion or fission-fusion hybrid reactors, is a possible solution for future world's energy demands. Formation of uniform layers of a condensed hydrogen fuel in ICF targets has been a long standing materials physics challenge. Here, we review the progress in this field. After a brief discussion of the major ICF target designs and the basic properties of condensed hydrogens, we review both liquid and solid layering methods, physical mechanisms causing layer nonuniformity, growth of hydrogen single crystals, attempts to prepare amorphous and nanostructured hydrogens, and mechanical deformation behavior. Emphasis is given to current challenges defining future research areas in the field of condensed hydrogens for fusion energy applications.

  16. Membrane tension and membrane fusion.

    PubMed

    Kozlov, Michael M; Chernomordik, Leonid V

    2015-08-01

    Diverse cell biological processes that involve shaping and remodeling of cell membranes are regulated by membrane lateral tension. Here we focus on the role of tension in driving membrane fusion. We discuss the physics of membrane tension, forces that can generate the tension in plasma membrane of a cell, and the hypothesis that tension powers expansion of membrane fusion pores in late stages of cell-to-cell and exocytotic fusion. We propose that fusion pore expansion can require unusually large membrane tensions or, alternatively, low line tensions of the pore resulting from accumulation in the pore rim of membrane-bending proteins. Increase of the inter-membrane distance facilitates the reaction. PMID:26282924

  17. Information fusion for palmprint authentication

    NASA Astrophysics Data System (ADS)

    Wu, Xiangqian; Wang, Kuanquan; Zhang, David

    2006-04-01

    A palmprint can be represented using different features and the different representations reflect the different characteristic of a palmprint. Fusion of multiple palmprint features may enhance the performance of a palmprint authentication system. This paper investigates the fusion of two types of palmprint information: the phase (called PalmCode) and the orientation (called OrientationCode). The PalmCode is extracted using the 2-D Gabor filters based algorithm and the OrientationCode is computed using several directional templates. Then several fusion strategies are investigated and compared. The experimental results show that the fusion of the PalmCode and OrientationCode using the Product, Sum and Weighted Sum strategies can greatly improve the accuracy of palmprint authentication, which is up to 99.6%.

  18. Pulsed Power Driven Fusion Energy

    SciTech Connect

    SLUTZ,STEPHEN A.

    1999-11-22

    Pulsed power is a robust and inexpensive technology for obtaining high powers. Considerable progress has been made on developing light ion beams as a means of transporting this power to inertial fusion capsules. However, further progress is hampered by the lack of an adequate ion source. Alternatively, z-pinches can efficiently convert pulsed power into thermal radiation, which can be used to drive an inertial fusion capsule. However, a z-pinch driven fusion explosion will destroy a portion of the transmission line that delivers the electrical power to the z-pinch. They investigate several options for providing standoff for z-pinch driven fusion. Recyclable Transmission Lines (RTLs) appear to be the most promising approach.

  19. Mulitvariate Visualization with Data Fusion

    SciTech Connect

    Wong, Pak C.; Foote, Harlan P.; Kao, David L.; Leung, Lai R.; Thomas, James J.

    2002-12-26

    We discuss a fusion-based visualization method to analyze a 2D flow field together with its related scalars. The primary difference between a conventional visualization and a fusion-based visuali-zation is that the former draws on a single image whereas the latter draws on multiple see-through layers, which are then over-laid on each other to form the final visualization. We propose uniquely designed colormaps to highlight flow features that would not be shown with conventional colormaps. We present fusion techniques that integrate multiple single-purpose flow visualiza-tion techniques into the same viewing space. Our highly flexible fusion approach allows scientists to explore multiple parameters concurrently by mixing and matching images without frequently reconstructing new visualizations from its data for every possible combination. Sample datasets collected from a climate modeling study are used to demonstrate our approach

  20. Mulitvariate Visualization with Data Fusion

    SciTech Connect

    Wong, Pak C.; Foote, Harlan P.; Kao, David L.; Leung, Lai R.; Thomas, James J.

    2002-12-31

    We discuss a fusion-based visualization method to analyze a 2D flow field together with its related scalars. The primary difference between a conventional visualization and a fusion-based visuali-zation is that the former draws on a single image whereas the latter draws on multiple see-through layers, which are then over-laid on each other to form the final visualization. We propose uniquely designed colormaps to highlight flow features that would not be shown with conventional colormaps. We present fusion techniques that integrate multiple single-purpose flow visualiza-tion techniques into the same viewing space. Our highly flexible fusion approach allows scientists to explore multiple parameters concurrently by mixing and matching images without frequently reconstructing new visualizations from its data for every possible combination. Sample datasets collected from a climate modeling study are used to demonstrate our approach

  1. Overview of fusion reactor safety

    NASA Astrophysics Data System (ADS)

    Cohen, S.; Crocker, J. G.

    Use of deuterium-tritium fusion reactors requires examination of several major safety and environmental issues: (1) tritium inventory control; (2) neutron activation of structural materials, fluid streams and reactor hall environment; (3) release of radioactivity from energy sources including lithium spill reactions, superconducting magnet stored energy release, and plasma disruptions; (4) high magnetic and electromagnetic fields associated with fusion reactor superconducting magnets and radio frequency heating devices; and (5) handling and disposal of radioactive waste. Early recognition of potential safety problems with fusion reactors provides the opportunity for improvement in design and materials to eliminate or greatly reduce these problems. With an early start in this endeavor, fusion should be among the lower risk technologies for generation of commercial electrical power.

  2. Laser fusion monthly -- August 1980

    SciTech Connect

    Ahlstrom, H.G.

    1980-08-01

    This report documents the monthly progress for the laser fusion research at Lawrence Livermore National Laboratory. First it gives facilities report for both the Shiva and Argus projects. Topics discussed include; laser system for the Nova Project; the fusion experiments analysis facility; optical/x-ray streak camera; Shiva Dante System temporal response; 2{omega}{sub 0} experiment; and planning for an ICF engineering test facility.

  3. Cavitation and Fusion

    NASA Astrophysics Data System (ADS)

    Stringham, Roger S.

    2005-12-01

    Natural cavitation phenomena in D2O using piezo devices, is now amplified initiating DD fusion events that produce heat and helium. The transient cavitation bubble produces micro accelerators in the form of jets containing high densities of deuterons, 1024-25/cc from the cavitating D2O. An electrically driven piezo device in a reactor filled with D2O produces jets that implant deuterons into a target foil producing 4He and T plus heat. There is no long range radiation associated with this process. We are moving in the direction of utilizing smaller systems by gaining faster and less expensive technology growth moving from successes at 0.2 and 0.4 MHz to 1.7 MHz. One of the results of our low frequency studies is a 1 to 3 MHz induced standing wave in our target foils. We are using sonoluminescence intensity as a tool to guide us in finding highest plasma density in the adiabatic bubble collapse process in the jet plasma formation. The generation of these sonoluminescence photons relates to conditions for the target implantation process. These experiments and the analytical methods have concentrated on the mass spectroscopy of reactor gases, calorimetry of the reactor and power supply, and the scanning electron microscope photographs of target foils. This work provides a path for an ecological and hydrocarbon-free energy source for all energy applications.

  4. Biomechanical evaluation of an endplate-conformed polycaprolactone-hydroxyapatite intervertebral fusion graft and its comparison with a typical nonconformed cortical graft.

    PubMed

    Agarwal, Aakash; Palepu, Vivek; Agarwal, Anand K; Goel, Vijay K; Yildirim, Eda D

    2013-06-01

    In the thoracolumbar region, between 7% and 30% of spinal fusion failures are at risk for pseudarthrosis. From a biomechanical perspective, the nonconformity of the intervertebral graft to the endplate surface could contribute to pseudarthrosis, given suboptimal stress distributions. The objective of this study was to quantify the effect of endplate-graft conformation on endplate stress distribution, maximum Von Mises stress development, and stability. The study design used an experimentally validated finite element (FE) model of the L4-L5 functional spinal unit to simulate two types of interbody grafts (cortical bone and polycaprolactone (PCL)-hydroxyapatite (HA) graft), with and without endplate-conformed surfaces. Two case studies were completed. In Case Study I, the endplate-conformed grafts and nonconformed grafts were compared under without posterior instrumentation condition, while in Case Study II, the endplate-conformed and nonconformed grafts were compared with posterior instrumentation. In both case studies, the results suggested that the increased endplate-graft conformity reduced the maximum stress on the endplate, created uniform stress distribution on endplate surfaces, and reduced the range of motion of L4-L5 segments by increasing the contact surface area between the graft and the endplate. The stress distributions in the endplate suggest that the load sharing is greater with the endplate-conformed PCL-HA graft, which might reduce the graft subsidence possibility. PMID:23699717

  5. Anterior cervical discectomy and fusion with titanium cages for simple or multilevel herniated discs and spur of the cervical spine: Report of 2 cases and experience in Bali

    PubMed Central

    Mahadewa Tjokorda, G. B.; Nyoman, Golden; Sri, Maliawan; Junichi, Mizuno

    2016-01-01

    This report presents two cases of cervicobrachialgia and radiculopathy due to multiple cervical herniated discs and spur formation that dealt with anterior cervical discectomy and fusion (ACDF) using different titanium interbody cages. The description of the clinical presentation, magnetic resonance imaging (MRI) appearances and management strategy are discussed. Both cases showed chronic neck pain and radiating pain from the shoulder to the arm. They had a history of blurry vision, cluster head ache, weakness, and numbness on the shoulder for 2 years. MRI revealed multiple herniated discs between C4-7 and accompanied by the spur formation leading to the narrowness of the spinal canal and its foramina bilaterally. ACDF were performed and complete decompression of the spinal canal and its foramina were carried out. Twin M-cages (Ammtec Inc.-Japan) were placed in the first case at C5-7 levels and single cage of Smith Robinson (SR) was placed in the second case at C5-6 levels. There were no more blurry vision, cluster headache, weakness, and numbness, immediately after surgery. To our knowledge, this is the first reported cases of ACDF, using twin M-cages and single SR cage in Indonesia, with improvement immediately after surgery. Cervical spondylosis can present with cervicobrachialgia and radiculopathy and surgical treatment produces good functional outcome.

  6. Anterior cervical discectomy and fusion with titanium cages for simple or multilevel herniated discs and spur of the cervical spine: Report of 2 cases and experience in Bali

    PubMed Central

    Mahadewa Tjokorda, G. B.; Nyoman, Golden; Sri, Maliawan; Junichi, Mizuno

    2016-01-01

    This report presents two cases of cervicobrachialgia and radiculopathy due to multiple cervical herniated discs and spur formation that dealt with anterior cervical discectomy and fusion (ACDF) using different titanium interbody cages. The description of the clinical presentation, magnetic resonance imaging (MRI) appearances and management strategy are discussed. Both cases showed chronic neck pain and radiating pain from the shoulder to the arm. They had a history of blurry vision, cluster head ache, weakness, and numbness on the shoulder for 2 years. MRI revealed multiple herniated discs between C4-7 and accompanied by the spur formation leading to the narrowness of the spinal canal and its foramina bilaterally. ACDF were performed and complete decompression of the spinal canal and its foramina were carried out. Twin M-cages (Ammtec Inc.-Japan) were placed in the first case at C5-7 levels and single cage of Smith Robinson (SR) was placed in the second case at C5-6 levels. There were no more blurry vision, cluster headache, weakness, and numbness, immediately after surgery. To our knowledge, this is the first reported cases of ACDF, using twin M-cages and single SR cage in Indonesia, with improvement immediately after surgery. Cervical spondylosis can present with cervicobrachialgia and radiculopathy and surgical treatment produces good functional outcome. PMID:27695567

  7. Prospects for Tokamak Fusion Reactors

    SciTech Connect

    Sheffield, J.; Galambos, J.

    1995-04-01

    This paper first reviews briefly the status and plans for research in magnetic fusion energy and discusses the prospects for the tokamak magnetic configuration to be the basis for a fusion power plant. Good progress has been made in achieving fusion reactor-level, deuterium-tritium (D-T) plasmas with the production of significant fusion power in the Joint European Torus (up to 2 MW) and the Tokamak Fusion Test Reactor (up to 10 MW) tokamaks. Advances on the technologies of heating, fueling, diagnostics, and materials supported these achievements. The successes have led to the initiation of the design phases of two tokamaks, the International Thermonuclear Experimental Reactor (ITER) and the US Toroidal Physics Experiment (TPX). ITER will demonstrate the controlled ignition and extended bum of D-T plasmas with steady state as an ultimate goal. ITER will further demonstrate technologies essential to a power plant in an integrated system and perform integrated testing of the high heat flux and nuclear components required to use fusion energy for practical purposes. TPX will complement ITER by testing advanced modes of steady-state plasma operation that, coupled with the developments in ITER, will lead to an optimized demonstration power plant.

  8. TRITIUM ACCOUNTANCY IN FUSION SYSTEMS

    SciTech Connect

    Klein, J. E.; Farmer, D. A.; Moore, M. L.; Tovo, L. L.; Poore, A. S.; Clark, E. A.; Harvel, C. D.

    2014-03-06

    The US Department of Energy (DOE) has clearly defined requirements for nuclear material control and accountability (MC&A) of tritium whereas the International Atomic Energy Agency (IAEA) does not since tritium is not a fissile material. MC&A requirements are expected for tritium fusion machines and will be dictated by the host country or regulatory body where the machine is operated. Material Balance Areas (MBAs) are defined to aid in the tracking and reporting of nuclear material movements and inventories. Material subaccounts (MSAs) are established along with key measurement points (KMPs) to further subdivide a MBA to localize and minimize uncertainties in the inventory difference (ID) calculations for tritium accountancy. Fusion systems try to minimize tritium inventory which may require continuous movement of material through the MSAs. The ability of making meaningful measurements of these material transfers is described in terms of establishing the MSA structure to perform and reconcile ID calculations. For fusion machines, changes to the traditional ID equation will be discussed which includes breading, burn-up, and retention of tritium in the fusion device. The concept of “net” tritium quantities consumed or lost in fusion devices is described in terms of inventory taking strategies and how it is used to track the accumulation of tritium in components or fusion machines.

  9. Tritium accountancy in fusion systems

    SciTech Connect

    Klein, J.E.; Clark, E.A.; Harvel, C.D.; Farmer, D.A.; Tovo, L.L.; Poore, A.S.; Moore, M.L.

    2015-03-15

    The US Department of Energy (DOE) has clearly defined requirements for nuclear material control and accountability (MCA) of tritium whereas the International Atomic Energy Agency (IAEA) does not since tritium is not a fissile material. MCA requirements are expected for tritium fusion machines and will be dictated by the host country or regulatory body where the machine is operated. Material Balance Areas (MBA) are defined to aid in the tracking and reporting of nuclear material movements and inventories. Material sub-accounts (MSA) are established along with key measurement points (KMP) to further subdivide a MBA to localize and minimize uncertainties in the inventory difference (ID) calculations for tritium accountancy. Fusion systems try to minimize tritium inventory which may require continuous movement of material through the MSA. The ability of making meaningful measurements of these material transfers is described in terms of establishing the MSA structure to perform and reconcile ID calculations. For fusion machines, changes to the traditional ID equation will be discussed which includes breeding, burn-up, and retention of tritium in the fusion device. The concept of 'net' tritium quantities consumed or lost in fusion devices is described in terms of inventory taking strategies and how it is used to track the accumulation of tritium in components or fusion machines. (authors)

  10. Novel Hydrophobin Fusion Tags for Plant-Produced Fusion Proteins

    PubMed Central

    Ritala, Anneli; Linder, Markus; Joensuu, Jussi

    2016-01-01

    Hydrophobin fusion technology has been applied in the expression of several recombinant proteins in plants. Until now, the technology has relied exclusively on the Trichoderma reesei hydrophobin HFBI. We screened eight novel hydrophobin tags, T. reesei HFBII, HFBIII, HFBIV, HFBV, HFBVI and Fusarium verticillioides derived HYD3, HYD4 and HYD5, for production of fusion proteins in plants and purification by two-phase separation. To study the properties of the hydrophobins, we used N-terminal and C-terminal GFP as a fusion partner. Transient expression of the hydrophobin fusions in Nicotiana benthamiana revealed large variability in accumulation levels, which was also reflected in formation of protein bodies. In two-phase separations, only HFBII and HFBIV were able to concentrate GFP into the surfactant phase from a plant extract. The separation efficiency of both tags was comparable to HFBI. When the accumulation was tested side by side, HFBII-GFP gave a better yield than HFBI-GFP, while the yield of HFBIV-GFP remained lower. Thus we present here two alternatives for HFBI as functional fusion tags for plant-based protein production and first step purification. PMID:27706254

  11. SKIDS data fusion project

    NASA Astrophysics Data System (ADS)

    Greenway, Phil

    1992-04-01

    The European Community's strategic research initiative in information technology (ESPRIT) has been in place for nearly five years. An early example of the pan-European collaborative projects being conducted under this initiative is 'SKIDS': Signal and Knowledge Integration with Decisional Control for Multisensory Systems. This four year project, which is approaching completion, aims to build a real-time multisensor perception machine. This machine will be capable of performing data fusion, interpretation, situation assessment, and resource allocation tasks, under the constraints of both time and resource availability, and in the presence of uncertain data. Of the many possible applications, the surveillance and monitoring of a semi-automated 'factory environment' has been chosen as a challenging and representative test scenario. This paper presents an overview of the goals and objectives of the project, the makeup of the consortium, and roles of the members within it, and the main technical achievements to data. In particular, the following are discussed: relevant application domains, and the generic requirements that can be inferred from them; sensor configuration, including choice, placement, etc.; control paradigms, including the possible trade-offs between centralized, hierarchical, and decentralized approaches; the corresponding hardware architectural choices, including the need for parallel processing; and the appropriate software architecture and infra-structure required to support the chosen task oriented approach. Specific attention is paid to the functional decomposition of the system and how the requirements for control impact the organization of the identified interpretation tasks. Future work and outstanding problems are considered in some concluding remarks. By virtue of limited space, this paper is descriptive rather than explanatory.

  12. Fusion Plasma Theory project summaries

    SciTech Connect

    Not Available

    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 US 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 US Fusion Energy Program.

  13. Kinetic advantage of controlled intermediate nuclear fusion

    SciTech Connect

    Guo Xiaoming

    2012-09-26

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

  14. 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.

  15. Accelerators for Fusion Materials Testing

    NASA Astrophysics Data System (ADS)

    Knaster, Juan; Okumura, Yoshikazu

    Fusion materials research is a worldwide endeavor as old as the parallel one working toward the long term stable confinement of ignited plasma. In a fusion reactor, the preservation of the required minimum thermomechanical properties of the in-vessel components exposed to the severe irradiation and heat flux conditions is an indispensable factor for safe operation; it is also an essential goal for the economic viability of fusion. Energy from fusion power will be extracted from the 14 MeV neutron freed as a product of the deuterium-tritium fusion reactions; thus, this kinetic energy must be absorbed and efficiently evacuated and electricity eventually generated by the conventional methods of a thermal power plant. Worldwide technological efforts to understand the degradation of materials exposed to 14 MeV neutron fluxes > 1018 m-2s-1, as expected in future fusion power plants, have been intense over the last four decades. Existing neutron sources can reach suitable dpa ("displacement-per-atom", the figure of merit to assess materials degradation from being exposed to neutron irradiation), but the differences in the neutron spectrum of fission reactors and spallation sources do not allow one to unravel the physics and to anticipate the degradation of materials exposed to fusion neutrons. Fusion irradiation conditions can be achieved through Li (d, xn) nuclear reactions with suitable deuteron beam current and energy, and an adequate flowing lithium screen. This idea triggered in the late 1970s at Los Alamos National Laboratory (LANL) a campaign working toward the feasibility of continuous wave (CW) high current linacs framed by the Fusion Materials Irradiation Test (FMIT) project. These efforts continued with the Low Energy Demonstrating Accelerator (LEDA) (a validating prototype of the canceled Accelerator Production of Tritium (APT) project), which was proposed in 2002 to the fusion community as a 6.7MeV, 100mA CW beam injector for a Li (d, xn) source to bridge

  16. Accelerators for Fusion Materials Testing

    NASA Astrophysics Data System (ADS)

    Knaster, Juan; Okumura, Yoshikazu

    Fusion materials research is a worldwide endeavor as old as the parallel one working toward the long term stable confinement of ignited plasma. In a fusion reactor, the preservation of the required minimum thermomechanical properties of the in-vessel components exposed to the severe irradiation and heat flux conditions is an indispensable factor for safe operation; it is also an essential goal for the economic viability of fusion. Energy from fusion power will be extracted from the 14 MeV neutron freed as a product of the deuterium-tritium fusion reactions; thus, this kinetic energy must be absorbed and efficiently evacuated and electricity eventually generated by the conventional methods of a thermal power plant. Worldwide technological efforts to understand the degradation of materials exposed to 14 MeV neutron fluxes >1018 m-2s-1, as expected in future fusion power plants, have been intense over the last four decades. Existing neutron sources can reach suitable dpa (“displacement-per-atom”, the figure of merit to assess materials degradation from being exposed to neutron irradiation), but the differences in the neutron spectrum of fission reactors and spallation sources do not allow one to unravel the physics and to anticipate the degradation of materials exposed to fusion neutrons. Fusion irradiation conditions can be achieved through Li (d, xn) nuclear reactions with suitable deuteron beam current and energy, and an adequate flowing lithium screen. This idea triggered in the late 1970s at Los Alamos National Laboratory (LANL) a campaign working toward the feasibility of continuous wave (CW) high current linacs framed by the Fusion Materials Irradiation Test (FMIT) project. These efforts continued with the Low Energy Demonstrating Accelerator (LEDA) (a validating prototype of the canceled Accelerator Production of Tritium (APT) project), which was proposed in 2002 to the fusion community as a 6.7MeV, 100mA CW beam injector for a Li (d, xn) source to bridge

  17. Object recognition by active fusion

    NASA Astrophysics Data System (ADS)

    Prantl, Manfred; Kopp-Borotschnig, Hermann; Ganster, Harald; Sinclair, David; Pinz, Axel J.

    1996-10-01

    Today's computer vision applications often have to deal with multiple, uncertain, and incomplete visual information. In this paper, we apply a new method, termed 'active fusion', to the problem of generic object recognition. Active fusion provides a common framework for active selection and combination of information from multiple sources in order to arrive at a reliable result at reasonable costs. In our experimental setup we use a camera mounted on a 2m by 1.5m x/z-table observing objects placed on a rotating table. Zoom, pan, tilt, and aperture setting of the camera can be controlled by the system. We follow a part-based approach, trying to decompose objects into parts, which are modeled as geons. The active fusion system starts from an initial view of the objects placed on the table and is continuously trying to refine its current object hypotheses by requesting additional views. The implementation of active fusion on the basis of probability theory, Dempster-Shafer's theory of evidence and fuzzy set theory is discussed. First results demonstrating segmentation improvements by active fusion are presented.

  18. A Model for Membrane Fusion

    NASA Astrophysics Data System (ADS)

    Ngatchou, Annita

    2010-01-01

    Pheochromocytoma is a tumor of the adrenal gland which originates from chromaffin cells and is characterized by the secretion of excessive amounts of neurotransmitter which lead to high blood pressure and palpitations. Pheochromocytoma contain membrane bound granules that store neurotransmitter. The release of these stored molecules into the extracellular space occurs by fusion of the granule membrane with the cell plasma membrane, a process called exocytosis. The molecular mechanism of this membrane fusion is not well understood. It is proposed that the so called SNARE proteins [1] are the pillar of vesicle fusion as their cleavage by clostridial toxin notably, Botulinum neurotoxin and Tetanus toxin abrogate the secretion of neurotransmitter [2]. Here, I describe how physical principles are applied to a biological cell to explore the role of the vesicle SNARE protein synaptobrevin-2 in easing granule fusion. The data presented here suggest a paradigm according to which the movement of the C-terminal of synaptobrevin-2 disrupts the lipid bilayer to form a fusion pore through which molecules can exit.

  19. Fusion genes in solid tumors.

    PubMed

    Aman, P

    1999-08-01

    Tumor development in different cell types and tissue locations involves many pathways, distinct genes and exogenous factors. Tumor type-specific chromosome rearrangements resulting in fusion genes or promoter swapping are believed to be involved in the early development of many tumor types. They are present in almost all cases of a particular tumor type and cases have been described that carry only tumor type-specific translocations without any signs of other cytogenetic changes. The mechanisms behind chromosome rearrangements in solid tumors are largely unknown. Radiation is an important factor in thyroid carcinomas but no com-$bmon sequence motifs are made out in the break points of solid tumors. The fusion genes found in sarcomas are dominated by the transcription factor type of genes with the TLS/FUS and EWS series of fusion genes as the largest group. More than 50% of papillary thyroid carcinomas carry fusion proteins with tyrosine kinase activity. Rearrangements involving HMGIC, HMGIY, and PLAG1 are common in benign mesenchymal tumors and salivary gland adenomas. Many recurrent tumor translocations show a strict specificity for tumor type. This specificity can most likely be explained by the specific sets of target genes that are deregulated by the fusion gene products. Identification of the downstream target genes is currently the object of intense research and may provide us with information that will help design better diagnostic tools and eventually find a cure for these diseases.

  20. Hot fusion or cold fusion, best route to the SHEs?

    NASA Astrophysics Data System (ADS)

    Loveland, Walter

    2010-02-01

    Elements 102-113 have been synthesized using cold fusion reactions (Pb or Bi target nuclei, massive projectiles., E*=13 MeV, high survival probabilities,significant fusion hindrance). The production cross sections decrease with increasing ZCN with a cross section of 27 fb being measured for element 113. Synthesis of elements 102-108 by hot fusion reactions (actinide target nuclei, intermediate mass projectiles, E*=30-50 MeV, low survival probability, small fusion hindrance) shows decreasing production cross sections for Z=102 to Z=108 and then the cross sections level out at a few pb out to Z=118. Upper limit cross sections for the production of Z=120 nuclei in hot fusion reactions are ˜ 0.1 pb. How should one go forward to make nuclei with Z > 120 or with large neutron numbers, N ˜ 184? The cross section for the production of an evaporation residue, σEVR, is σEVR=σCNWsur where σCN is the complete fusion cross section and Wsur is the survival probability of the completely fused system. The complete fusion cross section can be written as σCN=∑J=0^J σcapture (Ec.m.,J)PCN( Ec.m.,J) where σcapture(Ec.m.,J) is the capture cross section and PCN is the probability that the projectile-target system will evolve inside the fission saddle point to form a completely fused system rather than reseparating (quasifission). I have used this formalism to make estimates of the best reactions to make new heavy nuclei using stable and radioactive beams. I conclude that stable beams offer the best opportunities to make new chemical elements and that radioactive beams offer new opportunities to make nuclei to study the atomic physics and chemistry of the heaviest elements. The radioactive beam reactions involve the light neutron-rich projectiles interacting in hot fusion reactions. If time permits I will also discuss recent experiments to make heavy nuclei using multi-nucleon transfer reactions. )

  1. The Path to Magnetic Fusion Energy

    SciTech Connect

    Prager, Stewart

    2011-05-04

    When the possibility of fusion as an energy source for electricity generation was realized in the 1950s, understanding of the plasma state was primitive. The fusion goal has been paced by, and has stimulated, the development of plasma physics. Our understanding of complex, nonlinear processes in plasmas is now mature. We can routinely produce and manipulate 100 million degree plasmas with remarkable finesse, and we can identify a path to commercial fusion power. The international experiment, ITER, will create a burning (self-sustained) plasma and produce 500 MW of thermal fusion power. This talk will summarize the progress in fusion research to date, and the remaining steps to fusion power.

  2. (Meeting on fusion reactor materials)

    SciTech Connect

    Jones, R.H. ); Klueh, R.L.; Rowcliffe, A.F.; Wiffen, F.W. ); Loomis, B.A. )

    1990-11-01

    During his visit to the KfK, Karlsruhe, F. W. Wiffen attended the IEA 12th Working Group Meeting on Fusion Reactor Materials. Plans were made for a low-activation materials workshop at Culham, UK, for April 1991, a data base workshop in Europe for June 1991, and a molecular dynamics workshop in the United States in 1991. At the 11th IEA Executive Committee on Fusion Materials, discussions centered on the recent FPAC and Colombo panel review in the United States and EC, respectively. The Committee also reviewed recent progress toward a neutron source in the United States (CWDD) and in Japan (ESNIT). A meeting with D. R. Harries (consultant to J. Darvas) yielded a useful overview of the EC technology program for fusion. Of particular interest to the US program is a strong effort on a conventional ferritic/martensitic steel for fist wall/blanket operation beyond NET/ITER.

  3. Bioenergetic roles of mitochondrial fusion.

    PubMed

    Silva Ramos, Eduardo; Larsson, Nils-Göran; Mourier, Arnaud

    2016-08-01

    Mitochondria are bioenergetic hotspots, producing the bulk of ATP by the oxidative phosphorylation process. Mitochondria are also structurally dynamic and undergo coordinated fusion and fission to maintain their function. Recent studies of the mitochondrial fusion machinery have provided new evidence in detailing their role in mitochondrial metabolism. Remarkably, mitofusin 2, in addition to its role in fusion, is important for maintaining coenzyme Q levels and may be an integral player in the mevalonate synthesis pathway. Here, we review the bioenergetic roles of mitochondrial dynamics and emphasize the importance of the in vitro growth conditions when evaluating mitochondrial respiration. This article is part of a Special Issue entitled 'EBEC 2016: 19th European Bioenergetics Conference, Riva del Garda, Italy, July 2-6, 2016,' edited by Prof. Paolo Bernardi. PMID:27060252

  4. Superconducting magnets for fusion applications

    SciTech Connect

    Henning, C.D.

    1987-07-02

    Fusion magnet technology has made spectacular advances in the past decade; to wit, the Mirror Fusion Test Facility and the Large Coil Project. However, further advances are still required for advanced economical fusion reactors. Higher fields to 14 T and radiation-hardened superconductors and insulators will be necessary. Coupled with high rates of nuclear heating and pulsed losses, the next-generation magnets will need still higher current density, better stability and quench protection. Cable-in-conduit conductors coupled with polyimide insulations and better steels seem to be the appropriate path. Neutron fluences up to 10/sup 19/ neutrons/cm/sup 2/ in niobium tin are achievable. In the future, other amorphous superconductors could raise these limits further to extend reactor life or decrease the neutron shielding and corresponding reactor size.

  5. Fusion Blanket Development in FDF

    NASA Astrophysics Data System (ADS)

    Wong, C. P. C.; Smith, J. P.; Stambaugh, R. D.

    2008-11-01

    To satisfy the electricity and tritium self-sufficiency missions of a Fusion Development Facility (FDF), suitable blanket designs will need to be evaluated, selected and developed. To demonstrate closure of the fusion fuel cycle, 2-3 main tritium breeding blankets will be used to cover most of the available chamber surface area in order to reach the project goal of achieving a tritium breeding ratio, TBR > 1. To demonstrate the feasibility of electricity and tritium production for subsequent devices such as the fusion demonstration power reactor (DEMO), several advanced test blankets will need to be selected and tested on the FDF to demonstrate high coolant outlet temperature necessary for efficient electricity production. Since the design goals for the main and test blankets are different, the design criteria of these blankets will also be different. The considerations in performing the evaluation of blanket and structural material options in concert with the maintenance approach for the FDF will be reported in this paper.

  6. Congress turns cold on fusion

    SciTech Connect

    Marshall, E.

    1984-06-22

    A 5% cut in fusion research budgets will force some programs to be dropped in order to keep the large machinery running unless US and European scientists collaborate instead of competing. Legislators became uneasy about the escalating costs of the new devices. The 1984 budget of $470 million for magnetic fusion research is only half the projected cost of the Tokomak Fusion Core Experiment (TFCX) planned to ignite, for the first time, a self-sustaining burn. Planning for the TCFX continued despite the message from Congress. Work at the large institutions at Princeton, MIT, etc. may survive at the expense of other programs, some of which will lose academic programs as well. Scientists point to the loss of new ideas and approaches when projects are cancelled. Enthusiasm is growing for international collaboration.

  7. Laser fusion experiments at LLL

    SciTech Connect

    Ahlstrom, H.G.

    1980-06-16

    These notes present the experimental basis and status for laser fusion as developed at LLL. Two other chapters, one authored by K.A. Brueckner and the other by C. Max, present the theoretical implosion physics and laser plasma interaction physics. The notes consist of six sections. The first is an introductory section which provides some of the history of inertial fusion and a simple explanation of the concepts involved. The second section presents an extensive discussion of diagnostic instrumentation used in the LLL Laser Fusion Program. The third section is a presentation of laser facilities and capabilities at LLL. The purpose here is to define capability, not to derive how it was obtained. The fourth and fifth sections present the experimental data on laser-plasma interaction and implosion physics. The last chapter is a short projection of the future.

  8. Tissue fusion over nonadhering surfaces

    PubMed Central

    Nier, Vincent; Deforet, Maxime; Duclos, Guillaume; Yevick, Hannah G.; Cochet-Escartin, Olivier; Marcq, Philippe; Silberzan, Pascal

    2015-01-01

    Tissue fusion eliminates physical voids in a tissue to form a continuous structure and is central to many processes in development and repair. Fusion events in vivo, particularly in embryonic development, often involve the purse-string contraction of a pluricellular actomyosin cable at the free edge. However, in vitro, adhesion of the cells to their substrate favors a closure mechanism mediated by lamellipodial protrusions, which has prevented a systematic study of the purse-string mechanism. Here, we show that monolayers can cover well-controlled mesoscopic nonadherent areas much larger than a cell size by purse-string closure and that active epithelial fluctuations are required for this process. We have formulated a simple stochastic model that includes purse-string contractility, tissue fluctuations, and effective friction to qualitatively and quantitatively account for the dynamics of closure. Our data suggest that, in vivo, tissue fusion adapts to the local environment by coordinating lamellipodial protrusions and purse-string contractions. PMID:26199417

  9. Method for vacuum fusion bonding

    DOEpatents

    Ackler, Harold D.; Swierkowski, Stefan P.; Tarte, Lisa A.; Hicks, Randall K.

    2001-01-01

    An improved vacuum fusion bonding structure and process for aligned bonding of large area glass plates, patterned with microchannels and access holes and slots, for elevated glass fusion temperatures. Vacuum pumpout of all components is through the bottom platform which yields an untouched, defect free top surface which greatly improves optical access through this smooth surface. Also, a completely non-adherent interlayer, such as graphite, with alignment and location features is located between the main steel platform and the glass plate pair, which makes large improvements in quality, yield, and ease of use, and enables aligned bonding of very large glass structures.

  10. Plasma physics goes beyond fusion

    NASA Astrophysics Data System (ADS)

    Franklin, Raoul

    2008-11-01

    I was interested to read the fusion supplement published with the October issue of Physics World. However, in asserting that fusion created the need to recognize plasma physics as a separate branch of the subject, Stephen Cowley, the new director of the United Kingdom Atomic Energy Authority, was not quite correct. In fact, the word "plasma" was appropriated from the Greek by the chemical physicist (and later Nobel laureate) Irving Langmuir in 1928. It was used to describe the positive column of a gas discharge, which was then the subject of research into better lighting sources and advertising displays, as well as the underlying science.

  11. Electromagnetic computations for fusion devices

    SciTech Connect

    Turner, L.R.

    1989-09-01

    Among the difficulties in making nuclear fusion a useful energy source, two important ones are producing the magnetic fields needed to drive and confine the plasma, and controlling the eddy currents induced in electrically conducting components by changing fields. All over the world, researchers are developing electromagnetic codes and employing them to compute electromagnetic effects. Ferromagnetic components of a fusion reactor introduce field distortions. Eddy currents are induced in the vacuum vessel, blanket and other torus components of a tokamak when the plasma current disrupts. These eddy currents lead to large forces, and 3-D codes are being developed to study the currents and forces. 35 refs., 6 figs.

  12. Z-Pinch Fusion Propulsion

    NASA Technical Reports Server (NTRS)

    Miernik, Janie

    2011-01-01

    Fusion-based nuclear propulsion has the potential to enable fast interplanetary transportation. Shorter trips are better for humans in the harmful radiation environment of deep space. Nuclear propulsion and power plants can enable high Ispand payload mass fractions because they require less fuel mass. Fusion energy research has characterized the Z-Pinch dense plasma focus method. (1) Lightning is form of pinched plasma electrical discharge phenomena. (2) Wire array Z-Pinch experiments are commonly studied and nuclear power plant configurations have been proposed. (3) Used in the field of Nuclear Weapons Effects (NWE) testing in the defense industry, nuclear weapon x-rays are simulated through Z-Pinch phenomena.

  13. Fusion bonding and alignment fixture

    DOEpatents

    Ackler, Harold D.; Swierkowski, Stefan P.; Tarte, Lisa A.; Hicks, Randall K.

    2000-01-01

    An improved vacuum fusion bonding structure and process for aligned bonding of large area glass plates, patterned with microchannels and access holes and slots, for elevated glass fusion temperatures. Vacuum pumpout of all the components is through the bottom platform which yields an untouched, defect free top surface which greatly improves optical access through this smooth surface. Also, a completely non-adherent interlayer, such as graphite, with alignment and location features is located between the main steel platform and the glass plate pair, which makes large improvements in quality, yield, and ease of use, and enables aligned bonding of very large glass structures.

  14. Fusion Breeder Program interim report

    SciTech Connect

    Moir, R.; Lee, J.D.; Neef, W.

    1982-06-11

    This interim report for the FY82 Fusion Breeder Program covers work performed during the scoping phase of the study, December, 1981-February 1982. The goals for the FY82 study are the identification and development of a reference blanket concept using the fission suppression concept and the definition of a development plan to further the fusion breeder application. The context of the study is the tandem mirror reactor, but emphasis is placed upon blanket engineering. A tokamak driver and blanket concept will be selected and studied in more detail during FY83.

  15. Comparison Study between Conventional Sequence and Slice-Encoding Metal Artifact Correction (SEMAC) in the Diagnosis of Postoperative Complications in Patients Receiving Lumbar Inter-Body Fusion and Pedicle Screw Fixation Surgery

    PubMed Central

    Han, Sol Bee; Kwon, Jong Won

    2016-01-01

    Background and Purpose Slice-Encoding Metal Artifact Correction (SEMAC) sequence is one of the metal artifact reduction techniques of anatomical structure, but there has been no report about evaluation of post-operative complications. The purpose of this article is to compare the anatomical visibility between fast spin echo (FSE) and FSE-SEMAC and to evaluate the additional value of FSE-SEMAC in diagnostic confidence of the complications. Materials and Methods We conducted a retrospective study with 54 patients who received lumbar spinal surgery and MR images including FSE-SEMAC. For the semi-quantitative evaluation, the visibility of anatomical structures (neural foramen, bone-inter-body cage interface, central canal, nerve root in epidural space, back muscle, and bone-pedicle screw interface) was evaluated. For qualitative evaluation, we evaluated FSE and FSE with FSE-SEMAC independently, and recorded the diagnostic confidence level of post-operative complications. Generalized estimating equation regression analysis was used for statistical analysis, and a weighted kappa was used for inter-observer agreement. Results Scores of 6 imaging findings with FSE-SEMAC were significantly higher than that of FSE (P-value < .0001). Inter-observer agreements show good reliability (weighted kappa = 0.45–0.75). Both reviewers deemed 37 (reviewer 1) or 19 more (reviewer 2) post-operative complications with FSE plus FSE-SEMAC, compared to FSE only. Except for central canal stenosis (P-value = .2408), diagnostic confidence level for other post-operative complications were significantly higher with FSE plus FSE-SEMAC (P-value = .0000) than FSE. Conclusions FSE-SEMAC significantly reduces image distortion, compared to FSE sequence in 3.0-T MR. Also, diagnostic confidence for post-operative complications was higher when FSE with additional FSE-SEMAC compared to FSE only. PMID:27711137

  16. Calculation of fusion product angular correlation coefficients for fusion plasmas

    SciTech Connect

    Murphy, T.J.

    1987-08-01

    The angular correlation coefficients for fusion products are calculated in the cases of Maxwellian and beam-target plasmas. Measurement of these coefficients as a localized ion temperature or fast-ion diagnostic is discussed. 8 refs., 7 figs., 1 tab.

  17. Equivalence of measurement space solution data fusion and complete fusion

    NASA Astrophysics Data System (ADS)

    Ceccherini, Simone

    2016-10-01

    Many observation systems are operating on space-borne and airborne platforms, as well as from ground-based stations, providing measurements of vertical profiles of atmospheric parameters. When independent measurements of the same profile are available data fusion methods can be used to combine them and exploit all the available information for a more comprehensive and accurate description of the atmospheric state. Several data fusion methods can be used. Among the others, both the measurement space solution data fusion method and the complete fusion method have the remarkable properties of using all the acquired information and of providing results that are independent from a priori information used in the individual retrievals. For this reason, though the two methods use two completely different procedures, it is reasonable to expect that they give the same results and in this paper the rigorous proof of the equivalence of the two methods is given. Therefore, the choice between them is only driven by the advantages of the different implementations.

  18. A Plan for the Development of Fusion Energy. Final Report to Fusion Energy Sciences Advisory Committee, Fusion Development Path Panel

    SciTech Connect

    None, None

    2003-03-05

    This report presents a plan for the deployment of a fusion demonstration power plant within 35 years, leading to commercial application of fusion energy by mid-century. The plan is derived from the necessary features of a demonstration fusion power plant and from the time scale defined by President Bush. It identifies critical milestones, key decision points, needed major facilities and required budgets.

  19. Advanced Concepts: Aneutronic Fusion Power and Propulsion

    NASA Technical Reports Server (NTRS)

    Chapman, John J.

    2012-01-01

    Aneutronic Fusion for In-Space thrust, power. Clean energy & potential nuclear gains. Fusion plant concepts, potential to use advanced fuels. Methods to harness ionic momentum for high Isp thrust plus direct power conversion into electricity will be presented.

  20. Cold fusion catalyzed by muons and electrons

    SciTech Connect

    Kulsrud, R.M.

    1990-10-01

    Two alternative methods have been suggested to produce fusion power at low temperature. The first, muon catalyzed fusion or MCF, uses muons to spontaneously catalyze fusion through the muon mesomolecule formation. Unfortunately, this method fails to generate enough fusion energy to supply the muons, by a factor of about ten. The physics of MCF is discussed, and a possible approach to increasing the number of MCF fusions generated by each muon is mentioned. The second method, which has become known as Cold Fusion,'' involves catalysis by electrons in electrolytic cells. The physics of this process, if it exists, is more mysterious than MCF. However, it now appears to be an artifact, the claims for its reality resting largely on experimental errors occurring in rather delicate experiments. However, a very low level of such fusion claimed by Jones may be real. Experiments in cold fusion will also be discussed.

  1. Z-Pinch Fusion for Energy Applications

    SciTech Connect

    SPIELMAN,RICK B.

    2000-01-01

    Z pinches, the oldest fusion concept, have recently been revisited in light of significant advances in the fields of plasma physics and pulsed power engineering. The possibility exists for z-pinch fusion to play a role in commercial energy applications. We report on work to develop z-pinch fusion concepts, the result of an extensive literature search, and the output for a congressionally-mandated workshop on fusion energy held in Snowmass, Co July 11-23,1999.

  2. Exo-endo cellulase fusion protein

    DOEpatents

    Bower, Benjamin S.; Larenas, Edmund A.; Mitchinson, Colin

    2012-01-17

    The present invention relates to a heterologous exo-endo cellulase fusion construct, which encodes a fusion protein having cellulolytic activity comprising a catalytic domain derived from a fungal exo-cellobiohydrolase and a catalytic domain derived from an endoglucanase. The invention also relates to vectors and fungal host cells comprising the heterologous exo-endo cellulase fusion construct as well as methods for producing a cellulase fusion protein and enzymatic cellulase compositions.

  3. Inertial confinement fusion (ICF) review

    SciTech Connect

    Hammer, D.; Dyson, F.; Fortson, N.; Novick, B.; Panofsky, W.; Rosenbluth, M.; Treiman, S.; York, H.

    1996-03-01

    During its 1996 winter study JASON reviewed the DOE Inertial Confinement Fusion (ICF) program. This included the National Ignition Facility (NIF) and proposed studies. The result of the review was to comment on the role of the ICF program in support of the DOE Science Based Stockpile Stewardship program.

  4. 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.

  5. Magnetic fusion: progress -> stagnation -> degradation

    NASA Astrophysics Data System (ADS)

    Zakharov, Leonid

    2012-10-01

    ``The theory of the failure of magnetic fusion,'' created in 2004 and presented to APS-2007 introduced the notion of the ``difficult'' and ``complicated'' stages of the program and described them details. At the first phase the emerging fusion science was created under strong leadership. Progress was visible on year to year basis, and the program was easy to manage. The complicated phase started in the late 1980s, when the plasma physics appeared to be incapable to implement the mission of ITER to test nuclear components of a fusion reactor. Then, the failure of TFTR (PPPL, USA) and JET (Culham, UK) in the mid 1990 to demonstrate QDT=1 and the blindness of their leaders to already visible means to resolve the problem, were a clear indication of an irreversible stagnation. In fact, right after 2007, it became clear that in the case of a large system of human ``particles'' (scientists) two phases have a continuation. The internal degrees of freedom, otherwise protected from external perturbations by a strong dedication to the scientific method, are now eroding and collapsing. The loss of science in addressing confinement, stability, power extraction, fueling, stationary regimes issues makes the current program irrelevant to fusion energy. A fresh approach should be taken.

  6. Magnetic fusion and project ITER

    SciTech Connect

    Park, H.K.

    1992-01-01

    It has already been demonstrated that our economics and international relationship are impacted by an energy crisis. For the continuing prosperity of the human race, a new and viable energy source must be developed within the next century. It is evident that the cost will be high and will require a long term commitment to achieve this goal due to a high degree of technological and scientific knowledge. Energy from the controlled nuclear fusion is a safe, competitive, and environmentally attractive but has not yet been completely conquered. Magnetic fusion is one of the most difficult technological challenges. In modem magnetic fusion devices, temperatures that are significantly higher than the temperatures of the sun have been achieved routinely and the successful generation of tens of million watts as a result of scientific break-even is expected from the deuterium and tritium experiment within the next few years. For the practical future fusion reactor, we need to develop reactor relevant materials and technologies. The international project called International Thermonuclear Experimental Reactor (ITER)'' will fulfill this need and the success of this project will provide the most attractive long-term energy source for mankind.

  7. Magnetic fusion and project ITER

    SciTech Connect

    Park, H.K.

    1992-09-01

    It has already been demonstrated that our economics and international relationship are impacted by an energy crisis. For the continuing prosperity of the human race, a new and viable energy source must be developed within the next century. It is evident that the cost will be high and will require a long term commitment to achieve this goal due to a high degree of technological and scientific knowledge. Energy from the controlled nuclear fusion is a safe, competitive, and environmentally attractive but has not yet been completely conquered. Magnetic fusion is one of the most difficult technological challenges. In modem magnetic fusion devices, temperatures that are significantly higher than the temperatures of the sun have been achieved routinely and the successful generation of tens of million watts as a result of scientific break-even is expected from the deuterium and tritium experiment within the next few years. For the practical future fusion reactor, we need to develop reactor relevant materials and technologies. The international project called ``International Thermonuclear Experimental Reactor (ITER)`` will fulfill this need and the success of this project will provide the most attractive long-term energy source for mankind.

  8. Fusion blanket inherent safety assessment

    SciTech Connect

    Sze, D.K.; Jung, J.; Cheng, E.T.

    1986-01-01

    The inherent safety aspect of TPSS reactor blankets has been investigated. The idea is to design the blanket so safe that cost savings can be realized such as through non-nuclear grading construction. If the blanket materials are carefully selected, inherent safety is feasible for fusion reactor blankets up to 5 to 10 MW/m/sup 2/ neutron wall loading.

  9. Proton Collimators for Fusion Reactors

    NASA Technical Reports Server (NTRS)

    Miley, George H.; Momota, Hiromu

    2003-01-01

    Proton collimators have been proposed for incorporation into inertial-electrostatic-confinement (IEC) fusion reactors. Such reactors have been envisioned as thrusters and sources of electric power for spacecraft and as sources of energetic protons in commercial ion-beam applications.

  10. Membrane fusion during phage lysis

    PubMed Central

    Berry, Joel; Kongari, Rohit; Cahill, Jesse; Young, Ry

    2015-01-01

    In general, phages cause lysis of the bacterial host to effect release of the progeny virions. Until recently, it was thought that degradation of the peptidoglycan (PG) was necessary and sufficient for osmotic bursting of the cell. Recently, we have shown that in Gram-negative hosts, phage lysis also requires the disruption of the outer membrane (OM). This is accomplished by spanins, which are phage-encoded proteins that connect the cytoplasmic membrane (inner membrane, IM) and the OM. The mechanism by which the spanins destroy the OM is unknown. Here we show that the spanins of the paradigm coliphage lambda mediate efficient membrane fusion. This supports the notion that the last step of lysis is the fusion of the IM and OM. Moreover, data are provided indicating that spanin-mediated fusion is regulated by the meshwork of the PG, thus coupling fusion to murein degradation by the phage endolysin. Because endolysin function requires the formation of μm-scale holes by the phage holin, the lysis pathway is seen to require dramatic dynamics on the part of the OM and IM, as well as destruction of the PG. PMID:25870259

  11. Fusion probability in heavy nuclei

    NASA Astrophysics Data System (ADS)

    Banerjee, Tathagata; Nath, S.; Pal, Santanu

    2015-03-01

    Background: Fusion between two massive nuclei is a very complex process and is characterized by three stages: (a) capture inside the potential barrier, (b) formation of an equilibrated compound nucleus (CN), and (c) statistical decay of the CN leading to a cold evaporation residue (ER) or fission. The second stage is the least understood of the three and is the most crucial in predicting yield of superheavy elements (SHE) formed in complete fusion reactions. Purpose: A systematic study of average fusion probability, , is undertaken to obtain a better understanding of its dependence on various reaction parameters. The study may also help to clearly demarcate onset of non-CN fission (NCNF), which causes fusion probability, PCN, to deviate from unity. Method: ER excitation functions for 52 reactions leading to CN in the mass region 170-220, which are available in the literature, have been compared with statistical model (SM) calculations. Capture cross sections have been obtained from a coupled-channels code. In the SM, shell corrections in both the level density and the fission barrier have been included. for these reactions has been extracted by comparing experimental and theoretical ER excitation functions in the energy range ˜5 %-35% above the potential barrier, where known effects of nuclear structure are insignificant. Results: has been shown to vary with entrance channel mass asymmetry, η (or charge product, ZpZt ), as well as with fissility of the CN, χCN. No parameter has been found to be adequate as a single scaling variable to determine . Approximate boundaries have been obtained from where starts deviating from unity. Conclusions: This study quite clearly reveals the limits of applicability of the SM in interpreting experimental observables from fusion reactions involving two massive nuclei. Deviation of from unity marks the beginning of the domain of dynamical models of fusion. Availability of precise ER cross

  12. Magnetized Target Fusion: Prospects for Low-Cost Fusion Energy

    NASA Technical Reports Server (NTRS)

    Siemon, Richard E.; Turchi, Peter J.; Barnes, Daniel C.; Degnan, James; Parks, Paul; Ryutov, Dmitri D.; Thio, Y. C. Francis; Schafer, Charles (Technical Monitor)

    2001-01-01

    Magnetized Target Fusion (MTF) has attracted renewed interest in recent years because it has the potential to resolve one of the major problems with conventional fusion energy research - the high cost of facilities to do experiments and in general develop practical fusion energy. The requirement for costly facilities can be traced to fundamental constraints. The Lawson condition implies large system size in the case of conventional magnetic confinement, or large heating power in the case of conventional inertial confinement. The MTF approach is to use much higher fuel density than with conventional magnetic confinement (corresponding to megabar pressures), which results in a much-reduced system size to achieve Lawson conditions. Intrinsically the system must be pulsed because the pressures exceed the strength of any known material. To facilitate heating the fuel (or "target") to thermonuclear conditions with a high-power high-intensity source of energy, magnetic fields are used to insulate the high-pressure fuel from material surroundings (thus "magnetized target"). Because of magnetic insulation, the required heating power intensity is reduced by many orders of magnitude compared to conventional inertial fusion, even with relatively poor energy confinement in the magnetic field, such as that characterized by Bohm diffusion. In this paper we show semi-quantitatively why MTF-should allow fusion energy production without costly facilities within the same generally accepted physical constraints used for conventional magnetic and inertial fusion. We also briefly discuss potential applications of this technology ranging from nuclear rockets for space propulsion to a practical commercial energy system. Finally, we report on the exploratory research underway, and the interesting physics issues that arise in the MTF regime of parameters. Experiments at Los Alamos are focused on formation of a suitable plasma target for compression, utilizing the knowledge base for compact

  13. An introduction to multisensor data fusion

    SciTech Connect

    Hall, D.L.; Llinas, J.

    1997-01-01

    Multisensor data fusion is an emerging technology applied to Department of Defense (DoD) areas such as automated target recognition, battlefield surveillance, and guidance and control of autonomous vehicles, and to non-DoD applications such as monitoring of complex machinery, medical diagnosis, and smart buildings. Techniques for multisensor data fusion are drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and other areas. This paper provides a tutorial on data fusion, introducing data fusion applications, process models, and identification of applicable techniques. Comments are made on the state-of-the-art in data fusion.

  14. Fusion energy calorimeter for the tokamak fusion test reactor

    SciTech Connect

    Jassby, D.L.; Imel, G.R.

    1981-04-01

    One and two-dimensional neutronic analyses treating the transport and scattering of neutrons and the production and transport of gamma rays in the TFTR demonstrate that the fusion energy production in a D-T pulse in the TFTR can be determined with an uncertainty of +- 15% or less, simply by integrating the measured profile of temperature increase along the central radial axis of a large hydrocarbon moderator that fills the bay between adjacent toroidal-field coils, just outside the vacuum vessel. Limitations in thermopile temperature measurements dictate a minimum fusion-neutron fluence at the vacuum vessel of the order of 10/sup 12/ n/cm/sup 2/ per pulse (a source strength of 10/sup 18/ n/pulse in TFTR), in order that this simple calorimeter can provide useful accuracy.

  15. West European magnetic confinement fusion research

    SciTech Connect

    McKenney, B.L.; McGrain, M. . Foreign Applied Sciences Assessment Center); Hazeltine, R.D. . Inst. for Fusion Studies); Gentle, K.W. ); Hogan, J.T. ); Porkolab, M. . Dept. of Physics); Sigmar

    1990-01-01

    This report presents a technical assessment and review of the West European program in magnetic confinement fusion by a panel of US scientists and engineers active in fusion research. Findings are based on the scientific and technical literature, on laboratory reports and preprints, and on the personal experiences and collaborations of the panel members. Concerned primarily with developments during the past 10 years, from 1979 to 1989, the report assesses West European fusion research in seven technical areas: tokamak experiments; magnetic confinement technology and engineering; fusion nuclear technology; alternate concepts; theory; fusion computations; and program organization. The main conclusion emerging from the analysis is that West European fusion research has attained a position of leadership in the international fusion program. This distinction reflects in large measure the remarkable achievements of the Joint European Torus (JET). However, West European fusion prominence extends beyond tokamak experimental physics: the program has demonstrated a breadth of skill in fusion science and technology that is not excelled in the international effort. It is expected that the West European primacy in central areas of confinement physics will be maintained or even increased during the early 1990s. The program's maturity and commitment kindle expectations of dramatic West European advances toward the fusion energy goal. For example, achievement of fusion breakeven is expected first in JET, before 1995.

  16. Fusion of Enveloped Viruses in Endosomes.

    PubMed

    White, Judith M; Whittaker, Gary R

    2016-06-01

    Ari Helenius launched the field of enveloped virus fusion in endosomes with a seminal paper in the Journal of Cell Biology in 1980. In the intervening years, a great deal has been learned about the structures and mechanisms of viral membrane fusion proteins as well as about the endosomes in which different enveloped viruses fuse and the endosomal cues that trigger fusion. We now recognize three classes of viral membrane fusion proteins based on structural criteria and four mechanisms of fusion triggering. After reviewing general features of viral membrane fusion proteins and viral fusion in endosomes, we delve into three characterized mechanisms for viral fusion triggering in endosomes: by low pH, by receptor binding plus low pH and by receptor binding plus the action of a protease. We end with a discussion of viruses that may employ novel endosomal fusion-triggering mechanisms. A key take-home message is that enveloped viruses that enter cells by fusing in endosomes traverse the endocytic pathway until they reach an endosome that has all of the environmental conditions (pH, proteases, ions, intracellular receptors and lipid composition) to (if needed) prime and (in all cases) trigger the fusion protein and to support membrane fusion.

  17. Molecular mechanism of mitochondrial membrane fusion.

    PubMed

    Griffin, Erik E; Detmer, Scott A; Chan, David C

    2006-01-01

    Mitochondrial fusion requires coordinated fusion of the outer and inner membranes. This process leads to exchange of contents, controls the shape of mitochondria, and is important for mitochondrial function. Two types of mitochondrial GTPases are essential for mitochondrial fusion. On the outer membrane, the fuzzy onions/mitofusin proteins form complexes in trans that mediate homotypic physical interactions between adjacent mitochondria and are likely directly involved in outer membrane fusion. Associated with the inner membrane, the OPA1 dynamin-family GTPase maintains membrane structure and is a good candidate for mediating inner membrane fusion. In yeast, Ugo1p binds to both of these GTPases to form a fusion complex, although a related protein has yet to be found in mammals. An understanding of the molecular mechanism of fusion may have implications for Charcot-Marie-Tooth subtype 2A and autosomal dominant optic atrophy, neurodegenerative diseases caused by mutations in Mfn2 and OPA1.

  18. Security on the US Fusion Grid

    SciTech Connect

    Burruss, Justin R.; Fredian, Tom W.; Thompson, Mary R.

    2005-06-01

    The National Fusion Collaboratory project is developing and deploying new distributed computing and remote collaboration technologies with the goal of advancing magnetic fusion energy research. This work has led to the development of the US Fusion Grid (FusionGrid), a computational grid composed of collaborative, compute, and data resources from the three large US fusion research facilities and with users both in the US and in Europe. Critical to the development of FusionGrid was the creation and deployment of technologies to ensure security in a heterogeneous environment. These solutions to the problems of authentication, authorization, data transfer, and secure data storage, as well as the lessons learned during the development of these solutions, may be applied outside of FusionGrid and scale to future computing infrastructures such as those for next-generation devices like ITER.

  19. Data security on the national fusion grid

    SciTech Connect

    Burruss, Justine R.; Fredian, Tom W.; Thompson, Mary R.

    2005-06-01

    The National Fusion Collaboratory project is developing and deploying new distributed computing and remote collaboration technologies with the goal of advancing magnetic fusion energy research. This work has led to the development of the US Fusion Grid (FusionGrid), a computational grid composed of collaborative, compute, and data resources from the three large US fusion research facilities and with users both in the US and in Europe. Critical to the development of FusionGrid was the creation and deployment of technologies to ensure security in a heterogeneous environment. These solutions to the problems of authentication, authorization, data transfer, and secure data storage, as well as the lessons learned during the development of these solutions, may be applied outside of FusionGrid and scale to future computing infrastructures such as those for next-generation devices like ITER.

  20. 2002 Fusion Summer Study Executive Summary

    NASA Astrophysics Data System (ADS)

    Bangerter, Roger; Navratil, Gerald; Sauthoff, Ned

    2001-09-01

    The 2002 Fusion Summer Study was conducted July 8-19, 2002, in Snowmass, CO, and carried out a critical assessment of major next steps in the fusion energy sciences program in both magnetic fusion energy (MFE) and inertial fusion energy (IFE). The conclusions of this study were based on analysis led by over 60 conveners working with hundreds of members of the fusion energy sciences community extending over eight months. This effort culminated in two weeks of intense discussion by over 250 U.S. and 30 foreign fusion physicists and engineers present at the 2002 Fusion Summer Study. This is the Executive Summary of the study report. Details are posted at http://web.gat.com/snowmass

  1. Measurement of the fusion probability, PCN, for hot fusion reactions

    NASA Astrophysics Data System (ADS)

    Yanez, R.; Loveland, W.; Barrett, J. S.; Yao, L.; Back, B. B.; Zhu, S.; Khoo, T. L.

    2013-07-01

    Background: The cross section for forming a heavy evaporation residue in fusion reactions depends on the capture cross section, the fusion probability, PCN, i.e., the probability that the projectile-target system will evolve inside the fission saddle point to form a completely fused system rather than reseparating (quasifission), and the survival of the completely fused system against fission. PCN is the least known of these quantities.Purpose: We want to determine PCN for the reactions of 101.2 MeV 18O, 147.3 MeV 26Mg, 170.9 MeV 30Si, and 195.3 MeV 36S with 197Au.Methods: We measured the fission fragment angular distributions for these reactions and used the formalism of Back to deduce the fusion-fission and quasifission cross sections. From these quantities we deduced PCN for each reaction.Results: The values of PCN for the reactions of 101.2 MeV 18O, 147.3 MeV 26Mg, 170.9 MeV 30Si, and 195.3 MeV 36S with 197Au are 0.66, 1.00, 0.06, and 0.13, respectively.Conclusions: The new measured values of PCN agree roughly with the semiempirical systematic dependence of PCN upon fissility for excited nuclei.

  2. Fission Fusion Hybrids: a nearer term application of Fusion

    NASA Astrophysics Data System (ADS)

    Kotschenreuther, M.; Valanju, P.; Mahajan, S.; Covele, B.

    2011-10-01

    Fission-fusion hybrids enjoy unique advantages for addressing long standing societal acceptability issues of nuclear fission power at a much lower level of technical development than a competitive fusion power plant. For waste incineration, hybrids burn intransigent transuranic residues (with the long lived biohazard) from light water reactors (LWRs). The number of hybrids needed is 5-10 times less than the corresponding number of fast reactors (FRs). The highly sub-critical hybrids, with a thermal/epithermal spectrum, incinerate > 95% of the waste in decades rather than the centuries needed for FRs. For fuel production, hybrids can produce fuel for 3-4 times as many LWRs with no fuel reprocessing. Thorium fuel rods exposed to neutrons in the hybrid reach fissile concentrations that enable efficient burning in LWR without the proliferation risks of reprocessing. The proliferation risks of this method are far less than other fuel breeding approaches, including today's gas centrifuge. With this cycle, US Thorium reserves could supply the entire US electricity supply for centuries. The centerpiece of the fuel cycle is a high power density Compact Fusion Neutron Source (major+minor radius ~ 2.5-3.5 m), which is made feasible by the super-X divertor.

  3. The elementary fusion modalities of osteoclasts.

    PubMed

    Søe, Kent; Hobolt-Pedersen, Anne-Sofie; Delaisse, Jean-Marie

    2015-04-01

    The last step of the osteoclast differentiation process is cell fusion. Most efforts to understand the fusion mechanism have focused on the identification of molecules involved in the fusion process. Surprisingly, the basic fusion modalities, which are well known for fusion of other cell types, are not known for the osteoclast. Here we show that osteoclast fusion partners are characterized by differences in mobility, nuclearity, and differentiation level. Our demonstration was based on time-laps videos of human osteoclast preparations from three donors where 656 fusion events were analyzed. Fusions between a mobile and an immobile partner were most frequent (62%), while fusion between two mobile (26%) or two immobile partners (12%) was less frequent (p<0.001). In general, the immobile fusion partner contained more nuclei than the mobile one (p<0.01). Furthermore, enrichment in nuclei of an osteoclast with three or more nuclei resulted from fusion with a mono-nucleated cell in 67% of the cases (p<0.001), while mono-nucleated cells fused with a multinucleated cell in 61% of the cases (p<0.05). This observation suggested that a more mature osteoclast prefers to fuse with a less mature pre-osteoclast. This hypothesis was supported by a nucleus-tracing approach in a co-culture of more and less differentiated pre-osteoclasts/osteoclasts. Furthermore, we found that osteoclast fusion proceeds through primarily two different types of cell contacts: phagocytic-cup and broad-contact-surfaces (>80% of all fusions). We conclude that osteoclasts most often gain nuclei by addition of one nucleus at a time, and that this nucleus is most often delivered by a moving cell to an immobile cell. These characteristics fit the in vivo observations where mono-nucleated precursors migrating from the bone marrow fuse with more mature osteoclasts sitting on the bone surface. They also fit the fusion modalities of other cell types.

  4. National mirror fusion program plan

    NASA Astrophysics Data System (ADS)

    Borchers, R. R.; Vanatta, C. M.

    1980-01-01

    Experiments are under way in the Tandem Mirror Experiment (TMX) facility at Livermore. Recently this idea was greatly improved by incorporating a new element called the thermal barrier, a concept that promises a higher power gain factor (Q = 10 to 20) with much less demanding neutral beam and magnet technology and a higher fusion power density in the reactor. In addition to the tandem-mirror experiments in TMX, a new attempt will be made in the Beta 2 facility during FY 1980 to create and sustain a field-reversed mirror configuration, which is a different mirror fusion approach that could lead to early commercialization of small reactors. The plan presented here is designed to exploit the results of these and other mirror experiments and theoretical developments toward a variety of applications. The main objective is electric power generation.

  5. Interpreting inertial fusion neutron spectra

    NASA Astrophysics Data System (ADS)

    Munro, David H.

    2016-03-01

    A burning laser fusion plasma produces a neutron spectrum first described by Brysk (1973 Plasma Phys. Control. Fusion 15 611). This and more recent work deals with the spectrum produced by a single fluid element. The distribution of temperatures and velocities in multiple fluid elements combine in any real spectrum; we derive formulas for how the neutron spectrum averages these contributions. The single element momentum spectrum is accurately Gaussian, but the multi-element spectrum exhibits higher moments. In particular, the skew and kurtosis are likely to be large enough to measure. Even the single fluid element spectrum may exhibit measurable directional anisotropy, so that instruments with different lines of sight should see different yields, mean velocities, mean temperatures, and higher moments. Finally, we briefly discuss how scattering in the imploded core modifies the neutron spectrum by changing the relative weighting of fuel regions with different temperatures and velocities.

  6. Prospects for toroidal fusion reactors

    SciTech Connect

    Sheffield, J.; Galambos, J.D.

    1994-06-01

    Work on the International Thermonuclear Experimental Reactor (ITER) tokamak has refined understanding of the realities of a deuterium-tritium (D-T) burning magnetic fusion reactor. An ITER-like tokamak reactor using ITER costs and performance would lead to a cost of electricity (COE) of about 130 mills/kWh. Advanced tokamak physics to be tested in the Toroidal Physics Experiment (TPX), coupled with moderate components in engineering, technology, and unit costs, should lead to a COE comparable with best existing fission systems around 60 mills/kWh. However, a larger unit size, {approximately}2000 MW(e), is favored for the fusion system. Alternative toroidal configurations to the conventional tokamak, such as the stellarator, reversed-field pinch, and field-reversed configuration, offer some potential advantage, but are less well developed, and have their own challenges.

  7. Interplanetary propulsion using inertial fusion

    NASA Technical Reports Server (NTRS)

    Orth, C. D.; Hogan, W. J.; Hoffman, N.; Murray, K.; Klein, G.; Diaz, F. C.

    1987-01-01

    Inertial fusion can be used to power spacecraft within the solar system and beyond. Such spacecraft have the potential for short-duration manned-mission performance exceeding other technologies. We are conducting a study to assess the systems aspects of inertial fusion as applied to such missions, based on the conceptual engine design of Hyde (1983) we describe the required systems for an entirely new spacecraft design called VISTA that is based on the use of DT fuel. We give preliminary design details for the power conversion and power conditioning systems for manned missions to Mars of total duration of about 100 days. Specific mission performance results will be published elsewhere, after the study has been completed.

  8. Investigation of condensed matter fusion

    SciTech Connect

    Jones, S.E.; Berrondo, M.; Czirr, J.B.; Decker, D.L.; Harrison, K.; Jensen, G.L.; Palmer, E.P.; Rees, L.B.; Taylor, S.; Vanfleet, H.B.; Wang, J.C.; Bennion, D.N.; Harb, J.N.; Pitt, W.G.; Thorne, J.M.; Anderson, A.N.; McMurtry, G.; Murphy, N.; Goff, F.E.

    1990-12-01

    Work on muon-catalyzed fusion led to research on a possible new type of fusion occurring in hydrogen isotopes embedded in metal lattices. While the nuclear-product yields observed to date are so small as to require careful further checking, rates observed over short times appear sufficiently large to suggest that significant neutrons and triton yields could be realized -- if the process could be understood and controlled. During 1990, we have developed two charged-particle detection systems and three new neutron detectors. A segmented, high-efficiency neutron counter was taken into 600 m underground in a mine in Colorado for studies out of the cosmic-ray background. Significant neutron emissions were observed in this environment in both deuterium-gas-loaded metals and in electrolytic cells, confirming our earlier observations.

  9. Mirror fusion vacuum technology developments

    SciTech Connect

    Batzer, T.H.; Call, W.R.

    1983-11-21

    Magnetic Mirror Fusion experiments, such as MFTF-B+T (Mirror Fusion Test Facility-B, Tritium Upgrade) and foreseeable follow-on devices, have operational and maintenance requirements that have not yet been fully demonstrated. Among those associated with vacuum technology are the very-high continuous-pumping speeds, 10/sup 7/ to 10/sup 8/ l/s for D/sub 2/, T/sub 2/ and, to a lesser extent, He; the early detection of water leaks from the very-high heat-flux neutral-beam dumps and the detection and location of leaks in the superconducting magnets not protected by guard vacuums. Possible solutions to these problems have been identified and considerable progress has been made toward successfully demonstrating their feasibility.

  10. Heavy Ion Fusion Injector Program

    SciTech Connect

    Yu, S.; Eylon, S.; Chupp, W.W.

    1993-05-01

    A program is underway to construct a 2 MV, 800 mA, K{sup +} injector for heavy ion fusion. The Electrostatic Quadrupole (ESQ) injector configuration consists of a zeolite source, a diode of up to 1 MV, together with several electrostatic quadrupole units to simultaneously focus and accelerate the beam to 2 MV. The key issues of source technology, high voltage breakdown, beam aberrations, and transient effects will be discussed. Results from ongoing experiments and simulations will be presented.

  11. FUSION WELDING METHOD AND APPARATUS

    DOEpatents

    Wyman, W.L.; Steinkamp, W.I.

    1961-01-17

    An apparatus for the fusion welding of metal pieces at a joint is described. The apparatus comprises a highvacuum chamber enclosing the metal pieces and a thermionic filament emitter. Sufficient power is applied to the emitter so that when the electron emission therefrom is focused on the joint it has sufficient energy to melt the metal pieces, ionize the metallic vapor abcve the molten metal, and establish an arc discharge between the joint and the emitter.

  12. Fusion for Earth and Space

    SciTech Connect

    Williams, Pharis E

    2009-03-16

    The compact reactor concept (Williams, 2007) has the potential to provide clean, safe and unlimited supply of energy for Earth and Space applications. The concept is a potential fusion reactor wherein deuterium nuclei are preferentially fused into helium nuclei. Because the deuterium nuclei are preferentially fused into helium nuclei at temperatures and energies lower than specified by the standard model there is no harmful radiation as a byproduct of this fusion process. Therefore, a reactor using this reaction does not need any shielding to contain such radiation. The energy released from each reaction and the absence of shielding makes the deuterium-plus-deuterium-to-helium (DDH) reactor very compact when compared to other reactors, both fission and fusion types. Moreover, the potential energy output per reactor weight and the absence of harmful radiation makes the DDH reactor an ideal candidate for individual home and space power. The concept also would make it possible for each plant or remote location to have it's own power source, on site, without the need for a connection to the power grid. This would minimize, or eliminate, power blackouts. The concept could replace large fission reactors and fossil fuel power plants plus provide energy for ships, locomotives, trucks and autos. It would make an ideal source of energy for space power applications and for space propulsion.

  13. Gasdynamic Mirror Fusion Propulsion Experiment

    NASA Technical Reports Server (NTRS)

    Emrich, William J., Jr.; Rodgers, Stephen L. (Technical Monitor)

    2001-01-01

    Nuclear fusion appears to be the most promising concept for producing extremely high specific impulse rocket engines. One particular fusion concept which seems to be particularly well suited for fusion propulsion applications is the gasdynamic mirror (GDM). This device would operate at much higher plasma densities and with much larger LD ratios than previous mirror machines. Several advantages accrue from such a design. First, the high LA:) ratio minimizes to a large extent certain magnetic curvature effects which lead to plasma instabilities causing a loss of plasma confinement. Second, the high plasma density will result in the plasma behaving much more Re a conventional fluid with a mean free path shorter than the length of the device. This characteristic helps reduce problems associated with "loss cone" microinstabilities. An experimental GDM device is currently being constructed at the NASA Marshall Space Flight Center to provide an initial assessment of the feasibility of this type of propulsion system. Initial experiments are expected to commence in the late fall of 2000.

  14. Fusion product measurements in tokamaks

    SciTech Connect

    Strachan, J.D.

    1985-05-01

    Diagnostic methods and the applications of fusion product measurements in tokamaks are reviewed with emphasis on results from PLT, PDX, and TFTR. Measurements have been made using the 2.5-MeV neutron from the d(d, n)/sup 3/ He reaction, the 3-MeV proton from the d(d, p)t reaction, both the 3.7-MeV alpha and the 14.7-MeV proton from the d(/sup 3/He, p)..cap alpha.. reaction, and the 14-MeV neutron from the d(t, n)..cap alpha.. reaction. The common use of these measurements is the determination of the ion temperature from the magnitude of the d-d neutron emission. For tokamak plasmas, these results are usually in good agreement with the charge exchange ion temperature. Recently, the charged fusion products have been used for high-resolution spectroscopic purposes, and emission profile measurements. Pitch angle resolution of the escaping 3-MeV proton emission has been used to determine the poloidal magnetic field inside the tokamak. Major issues in this field include the expected tritium operation on TFTR where the neutron measurements will determine when tritium will be introduced into the TFTR vessel and provide a measurement of the fusion power multiplication value (Q). The TFTR Q approx. 1 experiments will also provide a chance to measure the confinement of 3.5-MeV alphas in a tokamak.

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

    PubMed Central

    Foldvari, Marianna

    2015-01-01

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

  16. Fusion Nuclear Science Pathways Assessment

    SciTech Connect

    C.E. Kessel, et. al.

    2012-02-23

    With the strong commitment of the US to the success of the ITER burning plasma mission, and the project overall, it is prudent to consider how to take the most advantage of this investment. The production of energy from fusion has been a long sought goal, and the subject of several programmatic investigations and time line proposals [1]. The nuclear aspects of fusion research have largely been avoided experimentally for practical reasons, resulting in a strong emphasis on plasma science. Meanwhile, ITER has brought into focus how the interface between the plasma and engineering/technology, presents the most challenging problems for design. In fact, this situation is becoming the rule and no longer the exception. ITER will demonstrate the deposition of 0.5 GW of neutron heating to the blanket, deliver a heat load of 10-20 MW/m2 or more on the divertor, inject 50-100 MW of heating power to the plasma, all at the expected size scale of a power plant. However, in spite of this, and a number of other technologies relevant power plant, ITER will provide a low neutron exposure compared to the levels expected to a fusion power plant, and will purchase its tritium entirely from world reserves accumulated from decades of CANDU reactor operations. Such a decision for ITER is technically well founded, allowing the use of conventional materials and water coolant, avoiding the thick tritium breeding blankets required for tritium self-sufficiency, and allowing the concentration on burning plasma and plasma-engineering interface issues. The neutron fluence experienced in ITER over its entire lifetime will be ~ 0.3 MW-yr/m2, while a fusion power plant is expected to experience 120-180 MW-yr/m2 over its lifetime. ITER utilizes shielding blanket modules, with no tritium breeding, except in test blanket modules (TBM) located in 3 ports on the midplane [2], which will provide early tests of the fusion nuclear environment with very low tritium production (a few g per year).

  17. Materials issues in fusion reactors

    NASA Astrophysics Data System (ADS)

    Suri, A. K.; Krishnamurthy, N.; Batra, I. S.

    2010-02-01

    The world scientific community is presently engaged in one of the toughest technological tasks of the current century, namely, exploitation of nuclear fusion in a controlled manner for the benefit of mankind. Scientific feasibility of controlled fusion of the light elements in plasma under magnetic confinement has already been proven. International efforts in a coordinated and co-operative manner are presently being made to build ITER - the International Thermonuclear Experimental Reactor - to test, in this first step, the concept of 'Tokamak' for net fusion energy production. To exploit this new developing option of making energy available through the route of fusion, India too embarked on a robust fusion programme under which we now have a working tokamak - the Aditya and a steady state tokamak (SST-1), which is on the verge of functioning. The programme envisages further development in terms of making SST-2 followed by a DEMO and finally the fusion power reactor. Further, with the participation of India in the ITER program in 2005, and recent allocation of half - a - port in ITER for placing our Lead - Lithium Ceramic Breeder (LLCB) based Test Blanket Module (TBM), meant basically for breeding tritium and extracting high grade heat, the need to understand and address issues related to materials for these complex systems has become all the more necessary. Also, it is obvious that with increasing power from the SST stages to DEMO and further to PROTOTYPE, the increasing demands on performance of materials would necessitate discovery and development of new materials. Because of the 14.1 MeV neutrons that are generated in the D+T reaction exploited in a tokamak, the materials, especially those employed for the construction of the first wall, the diverter and the blanket segments, suffer crippling damage due to the high He/dpa ratios that result due to the high energy of the neutrons. To meet this challenge, the materials that need to be developed for the tokamaks

  18. Imaging multiple intermediates of single-virus membrane fusion mediated by distinct fusion proteins.

    PubMed

    Joo, Kye-Il; Tai, April; Lee, Chi-Lin; Wong, Clement; Wang, Pin

    2010-09-01

    Membrane fusion plays an essential role in the entry of enveloped viruses into target cells. The merging of viral and target cell membranes is catalyzed by viral fusion proteins, which involves multiple sequential steps in the fusion process. However, the fusion mechanisms mediated by different fusion proteins involve multiple transient intermediates that have not been well characterized. Here, we report a synthetic virus platform that allows us to better understand the different fusion mechanisms driven by the diverse types fusion proteins. The platform consists of lentiviral particles coenveloped with a surface antibody, which serves as the binding protein, along with a fusion protein derived from either influenza virus (HAmu) or Sindbis virus (SINmu). By using a single virus tracking technique, we demonstrated that both HAmu- and SINmu-bearing viruses enter cells through clathrin-dependent endocytosis, but they required different endosomal trafficking routes to initiate viral fusion. Direct observation of single viral fusion events clearly showed that hemifusion mediated by SINmu upon exposure to low pH occurs faster than that mediated by HAmu. Monitoring sequential fusion processes by dual labeling the outer and inner leaflets of viral membranes also revealed that the SINmu-mediated hemifusion intermediate is relatively long-lived as compared with that mediated by HAmu. Taken together, we have demonstrated that the combination of this versatile viral platform with the techniques of single virus tracking can be a powerful tool for revealing molecular details of fusion mediated by various fusion proteins.

  19. Study of fusion Q-value rule in sub-barrier fusion of heavy ions

    NASA Astrophysics Data System (ADS)

    Liu, Xing-Xing; Zhang, Gao-Long; Zhang, Huan-Qiao

    2015-07-01

    A vast body of fusion data has been analyzed for different projectiles and target nuclei. It is indicated that the sub-barrier fusion depends on the fusion Q-value. In terms of a recently introduced fusion Q-value rule and an energy scaling reduction procedure, the experimental fusion excitation functions are reduced and compared with each other. It is found that the reduced fusion excitations of selected fusion systems show a similar trend. The fusion data for massive nuclei are in agreement with the Q-value rule. In the fusion process, the Q contribution should be considered. Within this approach, the sub-barrier fusion cross sections of most fusion systems can be predicted without involving any structure effects of colliding nuclei. Instances of disagreement are presented in a few fusion systems. The use of the energy scaling as a criterion of possible experimental data inconsistency is discussed. More precise experimental fusion data need to be measured. Supported by National Nature Science Foundation of China (11475013, 11035007, 11175011), State Key Laboratory of Software Development Environment (SKLSDE-2014ZX-08), Fundamental Research Funds for the Central Universities and the Key Laboratory of High Precision Nuclear Spectroscopy, Institute of Modern Physics, Chinese Academy of Sciences

  20. Nuclear Fusion Award 2009 speech Nuclear Fusion Award 2009 speech

    NASA Astrophysics Data System (ADS)

    Sabbagh, Steven Anthony

    2011-01-01

    This is an exceptional moment in my career, and so I want to thank all of my teachers, colleagues and mentors who have made this possible. From my co-authors and myself, many thanks to the International Atomic Energy Agency, IOP Publishing, the Nuclear Fusion journal team, and the selection committee for the great honor of receiving this award. Also gratitude to Kikuchi-sensei, not only for the inventive and visionary creation of this award, but also for being a key mentor dating back to his efforts in producing high neutron output in JT-60U. It was also a great honor to receive the award directly from IAEA Deputy Director General Burkart during the 23rd IAEA Fusion Energy Conference in Daejeon. Receiving the award at this venue is particularly exciting as Daejeon is home to the new, next-generation KSTAR tokamak device that will lead key magnetic fusion research areas going forward. I would also like to thank the mayor of Daejeon, Dr Yum Hong-Chul, and all of the meeting organizers for giving us all a truly spectacular and singular welcoming event during which the award was presented. The research leading to the award would not have been possible without the support of the US Department of Energy, and I thank the Department for the continued funding of this research. Special mention must be made to a valuable co-author who is no longer with us, Professor A. Bondeson, who was a significant pioneer in resistive wall mode (RWM) research. I would like to thank my wife, Mary, for her infinite patience and encouragement. Finally, I would like to personally thank all of you that have approached and congratulated me directly. There are no units to measure how important your words have been in this regard. When notified that our paper had been shortlisted for the 2009 Nuclear Fusion Award, my co-authors responded echoing how I felt—honored to be included in such a fine collection of research by colleagues. It was unfathomable—would this paper follow the brilliant work

  1. Influence of breakup on fusion barrier distributions

    NASA Astrophysics Data System (ADS)

    Patel, D.; Nayak, B. K.; Mukherjee, S.; Biswas, D. C.; Mirgule, E. T.; John, B. V.; Gupta, Y. K.; Mukhopadhyay, S.; Prajapati, G.; Danu, L. S.; Rath, P. K.; Desai, V.; Deshmukh, N.; Saxena, A.

    2013-04-01

    Fusion barrier distributions have been extracted from the quasi-elastic scattering excitation functions, measured at backward angle θlab = 160° in reactions of 6,7Li+209Bi. The present results have been compared with the barrier distributions obtained from the fusion excitation function measurements for the above mentioned systems. The fusion barrier distributions from the quasi-elastic scattering excitation functions have been analyzed with simplified Coupled Channels calculations using Fresco. Inclusions of resonant states for both 6,7Li projectiles improve the predictions to describe the measured quasi-elastic scattering excitation functions and barrier distributions. For both the reactions peak positions of fusion barrier distributions are shifted towards a lower energy side in comparison to that obtained from the fusion excitation function measurements. The observed discrepancy in peak positions of barrier distributions obtained from quasi-elastic scattering and fusion excitation function measurements has been discussed in terms of total reaction threshold distribution.

  2. The Dark Side of Cell Fusion

    PubMed Central

    Bastida-Ruiz, Daniel; Van Hoesen, Kylie; Cohen, Marie

    2016-01-01

    Cell fusion is a physiological cellular process essential for fertilization, viral entry, muscle differentiation and placental development, among others. In this review, we will highlight the different cancer cell-cell fusions and the advantages obtained by these fusions. We will specially focus on the acquisition of metastatic features by cancer cells after fusion with bone marrow-derived cells. The mechanism by which cancer cells fuse with other cells has been poorly studied thus far, but the presence in several cancer cells of syncytin, a trophoblastic fusogen, leads us to a cancer cell fusion mechanism similar to the one used by the trophoblasts. The mechanism by which cancer cells perform the cell fusion could be an interesting target for cancer therapy. PMID:27136533

  3. Conceptual exploration package for data fusion

    NASA Astrophysics Data System (ADS)

    Jousselme, Anne-Laure; Grenier, Dominic; Bosse, Eloi

    2000-04-01

    In this paper, we present a software package designed to explore data fusion area applied to different contexts. This tool, called CEPfuse (Conceptual Exploration Package for Data Fusion) provides a good support to become familiar with all concepts and vocabulary linked to data fusion. Developed with Matlab 5.2, it's also a good tool to test, compare and analyze algorithms. Although the core of this package is evidential reasoning and identity information fusion, it has been conceived to develop all the interesting part of the Multi-Sensor Data Fusion system. Actually, because we concentrate our research work on identity information fusion, the principal included algorithms are Dempster- Shafer rules of combination, Shafer-Logan algorithms for hierarchical structures, and several decision rules.

  4. EDITORIAL: Safety aspects of fusion power plants

    NASA Astrophysics Data System (ADS)

    Kolbasov, B. N.

    2007-07-01

    This special issue of Nuclear Fusion contains 13 informative papers that were initially presented at the 8th IAEA Technical Meeting on Fusion Power Plant Safety held in Vienna, Austria, 10-13 July 2006. Following recommendation from the International Fusion Research Council, the IAEA organizes Technical Meetings on Fusion Safety with the aim to bring together experts to discuss the ongoing work, share new ideas and outline general guidance and recommendations on different issues related to safety and environmental (S&E) aspects of fusion research and power facilities. Previous meetings in this series were held in Vienna, Austria (1980), Ispra, Italy (1983), Culham, UK (1986), Jackson Hole, USA (1989), Toronto, Canada (1993), Naka, Japan (1996) and Cannes, France (2000). The recognized progress in fusion research and technology over the last quarter of a century has boosted the awareness of the potential of fusion to be a practically inexhaustible and clean source of energy. The decision to construct the International Thermonuclear Experimental Reactor (ITER) represents a landmark in the path to fusion power engineering. Ongoing activities to license ITER in France look for an adequate balance between technological and scientific deliverables and complying with safety requirements. Actually, this is the first instance of licensing a representative fusion machine, and it will very likely shape the way in which a more common basis for establishing safety standards and policies for licensing future fusion power plants will be developed. Now that ITER licensing activities are underway, it is becoming clear that the international fusion community should strengthen its efforts in the area of designing the next generations of fusion power plants—demonstrational and commercial. Therefore, the 8th IAEA Technical Meeting on Fusion Safety focused on the safety aspects of power facilities. Some ITER-related safety issues were reported and discussed owing to their potential

  5. Is Fusion Inhibited for Weakly Bound Nuclei?

    SciTech Connect

    Takahashi, J.; Munhoz, M.; Szanto, E.M.; Carlin, N.; Added, N.; Suaide, A.A.; de Moura, M.M.; Liguori Neto, R.; Szanto de Toledo, A.; Canto, L.F.

    1997-01-01

    Complete fusion of light radioactive nuclei is predicted to be hindered at near-barrier energies. This feature is investigated in the case of the least bound stable nuclei. Evaporation residues resulting from the {sup 6,7}Li+{sup 9}Be and {sup 6,7}Li+{sup 12}C fusion reactions have been measured in order to study common features in reactions involving light weakly bound nuclei. The experimental excitation functions revealed that the fusion cross section is significantly smaller than the total reaction cross section and also smaller than the fusion cross section expected from the available systematics. A clear correlation between the fusion probability and nucleon (cluster) separation energy has been established.The results suggest that the breakup process has a strong influence on the hindrance of the fusion cross section. {copyright} {ital 1996} {ital The American Physical Society}

  6. Lunar Helium-3 and Fusion Power

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The NASA Office of Exploration sponsored the NASA Lunar Helium-3 and Fusion Power Workshop. The meeting was held to understand the potential of using He-3 from the moon for terrestrial fusion power production. It provided an overview, two parallel working sessions, a review of sessions, and discussions. The lunar mining session concluded that mining, beneficiation, separation, and return of He-3 from the moon would be possible but that a large scale operation and improved technology is required. The fusion power session concluded that: (1) that He-3 offers significant, possibly compelling, advantages over fusion of tritium, principally increased reactor life, reduced radioactive wastes, and high efficiency conversion, (2) that detailed assessment of the potential of the D/He-3 fuel cycle requires more information, and (3) D/He-3 fusion may be best for commercial purposes, although D/T fusion is more near term.

  7. Incomplete fusion dynamics by spin distribution measurements

    SciTech Connect

    Singh, D.; Ali, R.; Ansari, M. Afzal; Singh, Pushpendra P.; Sharma, M. K.; Singh, B. P.; Babu, K. Surendra; Sinha, Rishi K.; Kumar, R.; Muralithar, S.; Singh, R. P.; Bhowmik, R. K.

    2010-02-15

    Spin distributions for various evaporation residues populated via complete and incomplete fusion of {sup 16}O with {sup 124}Sn at 6.3 MeV/nucleon have been measured, using charged particles (Z=1,2)-{gamma} coincidence technique. Experimentally measured spin distributions of the residues produced as incomplete fusion products associated with 'fast'{alpha}- and 2{alpha}-emission channels observed in the 'forward cone' are found to be distinctly different from those of the residues produced as complete fusion products. Moreover, 'fast'{alpha}-particles that arise from larger angular momentum in the entrance channel are populated at relatively higher driving input angular momentum than those produced through complete fusion. The incomplete fusion residues are populated in a limited, higher-angular-momentum range, in contrast to the complete fusion products, which are populated over a broad spin range.

  8. Inertial-confinement fusion with lasers

    NASA Astrophysics Data System (ADS)

    Betti, R.; Hurricane, O. A.

    2016-05-01

    The quest for controlled fusion energy has been ongoing for over a half century. The demonstration of ignition and energy gain from thermonuclear fuels in the laboratory has been a major goal of fusion research for decades. Thermonuclear ignition is widely considered a milestone in the development of fusion energy, as well as a major scientific achievement with important applications in national security and basic sciences. The US is arguably the world leader in the inertial confinement approach to fusion and has invested in large facilities to pursue it, with the objective of establishing the science related to the safety and reliability of the stockpile of nuclear weapons. Although significant progress has been made in recent years, major challenges still remain in the quest for thermonuclear ignition via laser fusion. Here, we review the current state of the art in inertial confinement fusion research and describe the underlying physical principles.

  9. History of Nuclear Fusion Research in Japan

    NASA Astrophysics Data System (ADS)

    Iguchi, Harukazu; Matsuoka, Keisuke; Kimura, Kazue; Namba, Chusei; Matsuda, Shinzaburo

    In the late 1950s just after the atomic energy research was opened worldwide, there was a lively discussion among scientists on the strategy of nuclear fusion research in Japan. Finally, decision was made that fusion research should be started from the basic, namely, research on plasma physics and from cultivation of human resources at universities under the Ministry of Education, Science and Culture (MOE). However, an endorsement was given that construction of an experimental device for fusion research would be approved sooner or later. Studies on toroidal plasma confinement started at Japan Atomic Energy Research Institute (JAERI) under the Science and Technology Agency (STA) in the mid-1960s. Dualistic fusion research framework in Japan was established. This structure has lasted until now. Fusion research activities over the last 50 years are described by the use of a flowchart, which is convenient to glance the historical development of fusion research in Japan.

  10. Line tension at lipid phase boundaries as driving force for HIV fusion peptide-mediated fusion

    NASA Astrophysics Data System (ADS)

    Yang, Sung-Tae; Kiessling, Volker; Tamm, Lukas K.

    2016-04-01

    Lipids and proteins are organized in cellular membranes in clusters, often called `lipid rafts'. Although raft-constituent ordered lipid domains are thought to be energetically unfavourable for membrane fusion, rafts have long been implicated in many biological fusion processes. For the case of HIV gp41-mediated membrane fusion, this apparent contradiction can be resolved by recognizing that the interfaces between ordered and disordered lipid domains are the predominant sites of fusion. Here we show that line tension at lipid domain boundaries contributes significant energy to drive gp41-fusion peptide-mediated fusion. This energy, which depends on the hydrophobic mismatch between ordered and disordered lipid domains, may contribute tens of kBT to fusion, that is, it is comparable to the energy required to form a lipid stalk intermediate. Line-active compounds such as vitamin E lower line tension in inhomogeneous membranes, thereby inhibit membrane fusion, and thus may be useful natural viral entry inhibitors.

  11. Line tension at lipid phase boundaries as driving force for HIV fusion peptide-mediated fusion.

    PubMed

    Yang, Sung-Tae; Kiessling, Volker; Tamm, Lukas K

    2016-01-01

    Lipids and proteins are organized in cellular membranes in clusters, often called 'lipid rafts'. Although raft-constituent ordered lipid domains are thought to be energetically unfavourable for membrane fusion, rafts have long been implicated in many biological fusion processes. For the case of HIV gp41-mediated membrane fusion, this apparent contradiction can be resolved by recognizing that the interfaces between ordered and disordered lipid domains are the predominant sites of fusion. Here we show that line tension at lipid domain boundaries contributes significant energy to drive gp41-fusion peptide-mediated fusion. This energy, which depends on the hydrophobic mismatch between ordered and disordered lipid domains, may contribute tens of kBT to fusion, that is, it is comparable to the energy required to form a lipid stalk intermediate. Line-active compounds such as vitamin E lower line tension in inhomogeneous membranes, thereby inhibit membrane fusion, and thus may be useful natural viral entry inhibitors. PMID:27113279

  12. Adaptive sensor fusion using genetic algorithms

    SciTech Connect

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

    1994-08-01

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

  13. An Alternate Development Path for Magnetic Fusion

    NASA Astrophysics Data System (ADS)

    Manheimer, Wallace

    2001-12-01

    Mid-century requirements for carbon free energy are daunting. Perhaps fusion could play a vital role. One of rather few possible solutions for sustainable development might be the fission fusion hybrid coupled with transmutation of the long lived actinide wastes. This paper suggests such an alternate development path for fusion, one that could lead to the production of multi-terawatts of carbon free power by 2050.

  14. Plasma Physics and Controlled Nuclear Fusion

    NASA Astrophysics Data System (ADS)

    Fisch, N. J.

    2010-01-01

    Already while making his famous contributions in uncontrolled nuclear fusion for wartime uses, Edward Teller contemplated how the abundant energy release through nuclear fusion might serve peacetime uses as well. His legacy in controlled nuclear fusion, and the associated physics of plasmas, spans both magnetic and inertial confinement approaches. His contributions in plasma physics, both the intellectual and the administrative, continue to impact the field.

  15. Review of alternative concepts for magnetic fusion

    SciTech Connect

    Krakowski, R.A.; Miller, R.L.; Hagenson, R.L.

    1980-01-01

    Although the Tokamak represents the mainstay of the world's quest for magnetic fusion power, with the tandem mirror serving as a primary backup concept in the US fusion program, a wide range of alternative fusion concepts (AFC's) have been and are being pursued. This review presents a summary of past and present reactor projections of a majority of AFC's. Whenever possible, quantitative results are given.

  16. Indirect drive targets for fusion power

    DOEpatents

    Amendt, Peter A.; Miles, Robin R.

    2016-10-11

    A hohlraum for an inertial confinement fusion power plant is disclosed. The hohlraum includes a generally cylindrical exterior surface, and an interior rugby ball-shaped surface. Windows over laser entrance holes at each end of the hohlraum enclose inert gas. Infrared reflectors on opposite sides of the central point reflect fusion chamber heat away from the capsule. P2 shields disposed on the infrared reflectors help assure an enhanced and more uniform x-ray bath for the fusion fuel capsule.

  17. Inertial fusion: strategy and economic potential

    SciTech Connect

    Nuckolls, J.H.

    1983-01-01

    Inertial fusion must demonstrate that the high target gains required for practical fusion energy can be achieved with driver energies not larger than a few megajoules. Before a multi-megajoule scale driver is constructed, inertial fusion must provide convincing experimental evidence that the required high target gains are feasible. This will be the principal objective of the NOVA laser experiments. Implosions will be conducted with scaled targets which are nearly hydrodynamically equivalent to the high gain target implosions. Experiments which demonstrate high target gains will be conducted in the early nineties when multi-megajoule drivers become available. Efficient drivers will also be demonstrated by this time period. Magnetic fusion may demonstrate high Q at about the same time as inertial fusion demonstrates high gain. Beyond demonstration of high performance fusion, economic considerations will predominate. Fusion energy will achieve full commercial success when it becomes cheaper than fission and coal. Analysis of the ultimate economic potential of inertial fusion suggests its costs may be reduced to half those of fission and coal. Relative cost escalation would increase this advantage. Fusions potential economic advantage derives from two fundamental properties: negligible fuel costs and high quality energy (which makes possible more efficient generation of electricity).

  18. Mitochondrial Fusion Is Essential for Steroid Biosynthesis

    PubMed Central

    Cooke, Mariana; Soria, Gastón; Cornejo Maciel, Fabiana; Gottifredi, Vanesa; Podestá, Ernesto J.

    2012-01-01

    Although the contribution of mitochondrial dynamics (a balance in fusion/fission events and changes in mitochondria subcellular distribution) to key biological process has been reported, the contribution of changes in mitochondrial fusion to achieve efficient steroid production has never been explored. The mitochondria are central during steroid synthesis and different enzymes are localized between the mitochondria and the endoplasmic reticulum to produce the final steroid hormone, thus suggesting that mitochondrial fusion might be relevant for this process. In the present study, we showed that the hormonal stimulation triggers mitochondrial fusion into tubular-shaped structures and we demonstrated that mitochondrial fusion does not only correlate-with but also is an essential step of steroid production, being both events depend on PKA activity. We also demonstrated that the hormone-stimulated relocalization of ERK1/2 in the mitochondrion, a critical step during steroidogenesis, depends on mitochondrial fusion. Additionally, we showed that the SHP2 phosphatase, which is required for full steroidogenesis, simultaneously modulates mitochondrial fusion and ERK1/2 localization in the mitochondrion. Strikingly, we found that mitofusin 2 (Mfn2) expression, a central protein for mitochondrial fusion, is upregulated immediately after hormone stimulation. Moreover, Mfn2 knockdown is sufficient to impair steroid biosynthesis. Together, our findings unveil an essential role for mitochondrial fusion during steroidogenesis. These discoveries highlight the importance of organelles’ reorganization in specialized cells, prompting the exploration of the impact that organelle dynamics has on biological processes that include, but are not limited to, steroid synthesis. PMID:23029265

  19. Fusion Concept Exploration Experiments at PPPL

    SciTech Connect

    Stewart Zweben; Samuel Cohen; Hantao Ji; Robert Kaita; Richard Majeski; Masaaki Yamada

    1999-05-01

    Small ''concept exploration'' experiments have for many years been an important part of the fusion research program at the Princeton Plasma Physics Laboratory (PPPL). this paper describes some of the present and planned fusion concept exploration experiments at PPPL. These experiments are a University-scale research level, in contrast with the larger fusion devices at PPPL such as the National Spherical Torus Experiment (NSTX) and the Tokamak Fusion Test Reactor (TFTR), which are at ''proof-of-principle'' and ''proof-of-performance'' levels, respectively.

  20. Mitochondrial fusion is essential for steroid biosynthesis.

    PubMed

    Duarte, Alejandra; Poderoso, Cecilia; Cooke, Mariana; Soria, Gastón; Cornejo Maciel, Fabiana; Gottifredi, Vanesa; Podestá, Ernesto J

    2012-01-01

    Although the contribution of mitochondrial dynamics (a balance in fusion/fission events and changes in mitochondria subcellular distribution) to key biological process has been reported, the contribution of changes in mitochondrial fusion to achieve efficient steroid production has never been explored. The mitochondria are central during steroid synthesis and different enzymes are localized between the mitochondria and the endoplasmic reticulum to produce the final steroid hormone, thus suggesting that mitochondrial fusion might be relevant for this process. In the present study, we showed that the hormonal stimulation triggers mitochondrial fusion into tubular-shaped structures and we demonstrated that mitochondrial fusion does not only correlate-with but also is an essential step of steroid production, being both events depend on PKA activity. We also demonstrated that the hormone-stimulated relocalization of ERK1/2 in the mitochondrion, a critical step during steroidogenesis, depends on mitochondrial fusion. Additionally, we showed that the SHP2 phosphatase, which is required for full steroidogenesis, simultaneously modulates mitochondrial fusion and ERK1/2 localization in the mitochondrion. Strikingly, we found that mitofusin 2 (Mfn2) expression, a central protein for mitochondrial fusion, is upregulated immediately after hormone stimulation. Moreover, Mfn2 knockdown is sufficient to impair steroid biosynthesis. Together, our findings unveil an essential role for mitochondrial fusion during steroidogenesis. These discoveries highlight the importance of organelles' reorganization in specialized cells, prompting the exploration of the impact that organelle dynamics has on biological processes that include, but are not limited to, steroid synthesis.

  1. Nuclear Fusion Award 2010 speech Nuclear Fusion Award 2010 speech

    NASA Astrophysics Data System (ADS)

    Rice, John

    2011-01-01

    Following the suggestion of Earl Marmar in 1995, I installed a compact von Hamos type x-ray spectrometer (originally built with Elisabeth Rachlew and Jan Kallne) on a tangentially viewing port on the Alcator C-Mod tokamak. The spectrometer views the plasma through a 2 cm diameter hole, and is tuned to H-like argon, suitable for passive measurement of the core toroidal rotation velocity from the Doppler shift. It soon became evident that the rotation in Ohmic L-mode discharges, while for the most part directed counter-current, depends in a very complicated fashion on plasma parameters, notably the electron density, current and magnetic configuration. The rotation can even flip sign for almost no apparent reason! In Ohmic and ion cyclotron range of frequencies (ICRF) heated H-mode plasmas the rotation is in the co-current direction and has a relatively simple dependence on plasma parameters, proportional to the stored energy normalized to the current. Rotation velocities as high as 130 km s-1 have been observed without external momentum input. In dimensionless terms this intrinsic (or spontaneous rotation) depends on the normalized plasma pressure. The association of toroidal rotation with plasma pressure in ICRF H-modes was first observed by Lars-Goran Eriksson in JET discharges. Similar results were subsequently reported for Tore Supra enhanced confinement plasmas. In the early 2000s concerns began to surface about the lack of substantial neutral beam driven rotation in ITER, and intrinsic rotation became a topic of interest in the ITPA Transport Group. Through that connection, similar observations from DIII-D, TCV and JT-60U were added to the growing list. A database of intrinsic rotation observations was assembled with the goal of extrapolating to the expected values for ITER. Both dimensional and dimensionless scalings were developed and formed the backbone of the 2007 Nuclear Fusion paper. I gratefully acknowledge the important contributions to this paper from

  2. Interplanetary propulsion using inertial fusion

    NASA Technical Reports Server (NTRS)

    Orth, Charles D.; Hoffman, Nate; Murray, Kathy; Klein, Gail; Diaz, Franklin Chang

    1987-01-01

    Inertial fusion can be used to power spacecraft within the solar system and beyond. Such spacecraft have the potential for short duration manned mission performance exceeding other technologies. A study was conducted to assess the systems aspects of inertial as applied to such missions, based on the conceptual engine design of Hyde (1983). The required systems for an entirely new spacecraft design called VISTA that is based on the use of DT fuel is described. Preliminary design details are given for the power conversion and power conditioning systems for manned missions to Mars of total duration of about 100 days.

  3. Modular stellarator fusion reactor concept

    NASA Astrophysics Data System (ADS)

    Miller, R. L.; Krakowski, R. A.

    1981-08-01

    A steady-state ignited, DT-fueled, magnetic fusion reactor is proposed for use as a central electric-power station. The MSR concept combines the physics of the classic stellarator confinement topology with an innovative, modular-coil design. Parametric tradeoff calculations are described, leading to the selection of an interim design point for a 4-GWt plant based on Alcator transport scaling and an average beta value of 0.04 in an 1 = 2 system with a plasma aspect ratio of 11. The physical basis of the design point is described together with supporting magnetics, coil-force, and stress computations.

  4. Tokamak Diagnostics Using Fusion Products.

    NASA Astrophysics Data System (ADS)

    Heidbrink, William Walter

    Measurements of neutrons and protons produced by the d(d,n)('3)He, d(t,n)(alpha), d(d,p)t, and d(('3)He,p)(alpha) fusion reactions are used to diagnose plasmas in the PLT and PDX tokamaks. An expression for the efficiency of proton detection is derived and confirmed experimentally. The time evolution of the ('3)He density indicates that a scoop limiter may pump ('3)He from the plasma faster than conventional limiters. The confinement of 1.0 MeV tritons and of 0.8 MeV ('3)He ions is studied by measuring the fraction of these fusion-produced ions that burn up in subsequent fusion reactions. In discharges with sawtooth activity and with B(,(phi)) > 2 T, the triton and ('3)He 'burnup' is consistent (within a factor of three) with predictions based on classical theories of ion confinement and slowing down. In discharges with large m = 2 or fishbone instabilities, the ('3)He burnup is less than classically predicted and, in PLT discharges at B(,(phi)) = 1.8 T, the triton burnup is over an order of magnitude smaller than predicted. Expressions for the energy spectrum of ions produced in beam-target fusion reactions are derived. Collimated measurements of the spectrum of 15 MeV protons produced by reactions between energetic ('3)He ions and relatively cold deuterons during fast wave minority heating indicate that the velocity distribution of fast ('3)He ions is peaked perpendicular to the tokamak magnetic field. The ion temperature profile and density of fast deuterons are measured with an array of collimated 3 MeV proton detectors. The fast ions produced by neutral beam injection and by launching lower hybrid waves are concentrated near the magnetic axis. Poloidal field measurements using 3 MeV protons also appear possible. In discharges in which the line radiation from central impurities does not decay, the plasma current profile is broader than in more typical discharges.

  5. Thomson scattering at general fusion

    NASA Astrophysics Data System (ADS)

    Young, W. C.; Parfeniuk, D.

    2016-11-01

    This paper provides an overview of the Thomson scattering diagnostic in use at General Fusion, including recent upgrades and upcoming plans. The plasma experiment under examination produces temperatures in the 50-500 eV range with density on the order of 1020 m-3. A four spatial point collection optics scheme has been implemented, with plans to expand to six spatial points. Recent changes to the optics of the laser beamline have reduced stray light. The system employs a frequency doubled Nd:YAG laser (532 nm), a grating spectrometer, and a photomultiplier array based detector.

  6. Laser fusion pulse shape controller

    DOEpatents

    Siebert, Larry D.

    1977-01-01

    An apparatus for controlling the pulse shape, i.e., the pulse duration and intensity pattern, of a pulsed laser system, and which is particularly well adapted for controlling the pellet ignition pulse in a laser-driven fusion reaction system. The apparatus comprises a laser generator for providing an optical control pulse of the shape desired, a pulsed laser triggered by the control pulse, and a plurality of optical Kerr-effect gates serially disposed at the output of the pulsed laser and selectively triggered by the control pulse to pass only a portion of the pulsed laser output generally corresponding in shape to the control pulse.

  7. Multisensor Fusion for Change Detection

    NASA Astrophysics Data System (ADS)

    Schenk, T.; Csatho, B.

    2005-12-01

    Combining sensors that record different properties of a 3-D scene leads to complementary and redundant information. If fused properly, a more robust and complete scene description becomes available. Moreover, fusion facilitates automatic procedures for object reconstruction and modeling. For example, aerial imaging sensors, hyperspectral scanning systems, and airborne laser scanning systems generate complementary data. We describe how data from these sensors can be fused for such diverse applications as mapping surface erosion and landslides, reconstructing urban scenes, monitoring urban land use and urban sprawl, and deriving velocities and surface changes of glaciers and ice sheets. An absolute prerequisite for successful fusion is a rigorous co-registration of the sensors involved. We establish a common 3-D reference frame by using sensor invariant features. Such features are caused by the same object space phenomena and are extracted in multiple steps from the individual sensors. After extracting, segmenting and grouping the features into more abstract entities, we discuss ways on how to automatically establish correspondences. This is followed by a brief description of rigorous mathematical models suitable to deal with linear and area features. In contrast to traditional, point-based registration methods, lineal and areal features lend themselves to a more robust and more accurate registration. More important, the chances to automate the registration process increases significantly. The result of the co-registration of the sensors is a unique transformation between the individual sensors and the object space. This makes spatial reasoning of extracted information more versatile; reasoning can be performed in sensor space or in 3-D space where domain knowledge about features and objects constrains reasoning processes, reduces the search space, and helps to make the problem well-posed. We demonstrate the feasibility of the proposed multisensor fusion approach

  8. A. Sakharov and Fusion Research

    NASA Astrophysics Data System (ADS)

    Coppi, Bruno

    2012-02-01

    In the landmark paper by Tamm and Sakharov [1], a controlled nuclear fusion reactor based on an axisymmetric magnetic confinement configuration whose principles remain valid to this day, was proposed. In the light of present understanding of plasma physics the virtues (e.g. that of considering the D-D reaction) and the shortcomings of this paper are pointed out. In fact, relatively recent results of theoretical plasma physics (e.g. discovery of the so called second stability region) and advances in high field magnet technology have made it possible to identify the parameters of meaningful experiments capable of exploring D-D and D-^3He burn conditions. At the same time an experimental program (IGNIR) has been undertaken through a (funded) collaboration between Italy and Russia to investigate D-T plasmas close to ignition conditions based on an advanced high field toroidal confinement configuration. A. Sakharov envisioned a bolder approach to fusion research than that advocated by some of his contemporaries. The time taken to design and decide to fabricate the first experiment capable of reaching ignition conditions is due in part to the problem of gaining an adequate understanding the expected physics of fusion burning plasmas. However, most of the relevant financial effort has gone in the pursuit of slow and indirect enterprises complying with the ``playing it safe'' tendencies of large organizations or motivated by the purpose to develop technologies or maintain a high level of expertise in plasma physics to the expected benefit of other kinds of endeavors. The creativity demonstrated by A. Sakharov in dealing with civil rights and disarmament issues is needed, while maintaining our concerns for energy and the environment on a global scale, to orient the funding for fusion research toward a direct and well based scientific effort on concepts for which a variety of developments can be envisioned. These can span from uncovering new physics relevant, for instance

  9. Introduction to Nuclear Fusion Power and the Design of Fusion Reactors. An Issue-Oriented Module.

    ERIC Educational Resources Information Center

    Fillo, J. A.

    This three-part module focuses on the principles of nuclear fusion and on the likely nature and components of a controlled-fusion power reactor. The physical conditions for a net energy release from fusion and two approaches (magnetic and inertial confinement) which are being developed to achieve this goal are described. Safety issues associated…

  10. 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

  11. Ch. 37, Inertial Fusion Energy Technology

    SciTech Connect

    Moses, E

    2010-06-09

    Nuclear fission, nuclear fusion, and renewable energy (including biofuels) are the only energy sources capable of satisfying the Earth's need for power for the next century and beyond without the negative environmental impacts of fossil fuels. Substantially increasing the use of nuclear fission and renewable energy now could help reduce dependency on fossil fuels, but nuclear fusion has the potential of becoming the ultimate base-load energy source. Fusion is an attractive fuel source because it is virtually inexhaustible, widely available, and lacks proliferation concerns. It also has a greatly reduced waste impact, and no danger of runaway reactions or meltdowns. The substantial environmental, commercial, and security benefits of fusion continue to motivate the research needed to make fusion power a reality. Replicating the fusion reactions that power the sun and stars to meet Earth's energy needs has been a long-sought scientific and engineering challenge. In fact, this technological challenge is arguably the most difficult ever undertaken. Even after roughly 60 years of worldwide research, much more remains to be learned. the magnitude of the task has caused some to declare that fusion is 20 years away, and always will be. This glib criticism ignores the enormous progress that has occurred during those decades, progress inboth scientific understanding and essential technologies that has enabled experiments producing significant amounts of fusion energy. For example, more than 15 megawatts of fusion power was produced in a pulse of about half a second. Practical fusion power plants will need to produce higher powers averaged over much longer periods of time. In addition, the most efficient experiments to date have required using about 50% more energy than the resulting fusion reaction generated. That is, there was no net energy gain, which is essential if fusion energy is to be a viable source of electricity. The simplest fusion fuels, the heavy isotopes of

  12. Magnetized Target Fusion Driven by Plasma Liners

    NASA Technical Reports Server (NTRS)

    Thio, Y. C. Francis; Kirkpatrick, Ronald C.; Knapp, Charles E.; Rodgers, Stephen L. (Technical Monitor)

    2002-01-01

    Magnetized target fusion is an emerging, relatively unexplored approach to fusion for electrical power and propulsion application. The physical principles of the concept are founded upon both inertial confinement fusion (ICF) and magnetic confinement fusion (MCF). It attempts to combine the favorable attributes of both these orthogonal approaches to fusion, but at the same time, avoiding the extreme technical challenges of both by exploiting a fusion regime intermediate between them. It uses a material liner to compress, heat and contain the fusion reacting plasma (the target plasma) mentally. By doing so, the fusion burn could be made to occur at plasma densities as high as six orders of magnitude higher than conventional MCF such as tokamak, thus leading to an approximately three orders of magnitude reduction in the plasma energy required for ignition. It also uses a transient magnetic field, compressed to extremely high intensity (100's T to 1000T) in the target plasma, to slow down the heat transport to the liner and to increase the energy deposition of charged-particle fusion products. This has several compounding beneficial effects. It leads to longer energy confinement time compared with conventional ICF without magnetized target, and thus permits the use of much lower plasma density to produce reasonable burn-up fraction. The compounding effects of lower plasma density and the magneto-insulation of the target lead to greatly reduced compressional heating power on the target. The increased energy deposition rate of charged-particle fusion products also helps to lower the energy threshold required for ignition and increasing the burn-up fraction. The reduction in ignition energy and the compressional power compound to lead to reduced system size, mass and R&D cost. It is a fusion approach that has an affordable R&D pathway, and appears attractive for propulsion application in the nearer term.

  13. Experiments in predictive sensor fusion

    NASA Astrophysics Data System (ADS)

    Keller, James M.; Auephanwiriyakul, Sansanee; Gader, Paul D.

    2001-10-01

    Data fusion is a process of combining evidence from different information sources in order to make a better judgement. However, multiple sources can provide complementary information that can be used to increase the performance in detection and recognition. There are many frameworks within which to combine these pieces into a more meaningful answer. However, new information added might be redundant or even conflicting with the existing information. These questions arise: can we predict the value added by fusing their outputs together, if we know the general characteristics of a set of sensors. Can we specify the needed characteristics of a new sensor/algorithm to add to an existing suite to gain a desired improvement performance. The characteristic of a new sensor can be in any forms, e.g., the ratio of a target's signal to the clutter's signal, the position resolution etc. In this paper, we consider these questions in the context of fuzzy set theory and in particular, a soft decision level fusion scheme we developed for land mine detection scenarios. Here, we primarily consider the ratio of a target's signal. We develop a tool to estimate a final d-metric when the information form several sensor is fused through the linguistic Choquet fuzzy integral. We utilize this tool in the examination of the performance of d-metrics in a simulation environment. The approach is demonstrated for data obtained from an Advanced Technology Demonstration in vehicle-based mine detection.

  14. Large excimer lasers for fusion

    SciTech Connect

    Jensen, R.J.

    1986-01-01

    Important goals in DOE and DOD programs require multimegajoule laser pulses. For inertial confinement fusion there is also a requirement to deliver the pulse in about 25 nsec with a very particular power vs time profile - all at high overall efficiency and low cost per joule. After exhaustive consideration of various alternatives, our studies have shown that the most cost effective approach to energy scaling is to increase the size of the final amplifiers up to the 200 to 300 kJ level. This conclusion derives largely from the fact that, at a given complexity, costs increase slowly with increasing part size while output energy should increase dramatically. Extrapolations to low cost by drastic cuts in the unit cost of smaller devices through mass production are considered highly risky. At a minimum the requirement to provide, space, optics and mounts for such systems will remain expensive. In recent years there have been dramatic advances in scaling. The Los Alamos LAM has produced over 10 kJ in a single 1/2 nsec pulse. In this paper we explore the issues involved in scaling to higher energy while still maintaining high efficiencies. In the remainder of this paper we will discuss KrF laser scaling for the fusion mission. We will omit most of the discussion of the laser system design, but address only KrF amplifiers.

  15. Computer Modeling of a Fusion Plasma

    SciTech Connect

    Cohen, B I

    2000-12-15

    Progress in the study of plasma physics and controlled fusion has been profoundly influenced by dramatic increases in computing capability. Computational plasma physics has become an equal partner with experiment and traditional theory. This presentation illustrates some of the progress in computer modeling of plasma physics and controlled fusion.

  16. Application of polarized nuclei to fusion

    SciTech Connect

    Kulsrud, R.M.

    1987-07-01

    It is shown that the d-t fusion reaction can be modified by polarizing nuclear spins. The ways in which this improves reactor performance are mentioned and the feasibility of the process of spin polarization for magnetic fusion is discussed. 18 refs.

  17. Plasma physics and controlled thermonuclear fusion

    SciTech Connect

    Krikorian, R. )

    1989-01-01

    This proceedings contains papers on plasma physics and controlled thermonuclear fusion. Included are the following topics: Plasma focus and Z-pinch, Review of mirror fusion research, Progress in studies of x-ray and ion-beam emission from plasma focus facilities.

  18. Plasmas are Hot and Fusion is Cool

    SciTech Connect

    2011-01-01

    Plasmas are Hot and Fusion is Cold. The DOE Princeton Plasma Physics Laboratory (PPPL) collaborates to develop fusion as a safe, clean and abundant energy source for the future. This video discusses PPPL's research and development on plasma, the fourth state of matter.

  19. Method of controlling fusion reaction rates

    DOEpatents

    Kulsrud, Russell M.; Furth, Harold P.; Valeo, Ernest J.; Goldhaber, Maurice

    1988-01-01

    A method of controlling the reaction rates of the fuel atoms in a fusion reactor comprises the step of polarizing the nuclei of the fuel atoms in a particular direction relative to the plasma confining magnetic field. Fusion reaction rates can be increased or decreased, and the direction of emission of the reaction products can be controlled, depending on the choice of polarization direction.

  20. Method of controlling fusion reaction rates

    DOEpatents

    Kulsrud, Russell M.; Furth, Harold P.; Valeo, Ernest J.; Goldhaber, Maurice

    1988-03-01

    A method of controlling the reaction rates of the fuel atoms in a fusion reactor comprises the step of polarizing the nuclei of the fuel atoms in a particular direction relative to the plasma confining magnetic field. Fusion reaction rates can be increased or decreased, and the direction of emission of the reaction products can be controlled, depending on the choice of polarization direction.

  1. 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.

  2. Controlled Nuclear Fusion: Status and Outlook

    ERIC Educational Resources Information Center

    Rose, David J.

    1971-01-01

    Presents the history, current concerns and potential developments of nuclear fusion as a major energy source. Controlled fusion research is summarized, technological feasibility is discussed and environmental factors are examined. Relationships of alternative energy sources as well as energy utilization are considered. (JM)

  3. Fusion Propulsion Z-Pinch Engine Concept

    NASA Technical Reports Server (NTRS)

    Miernik, J.; Statham, G.; Fabisinski, L.; Maples, C. D.; Adams, R.; Polsgrove, T.; Fincher, S.; Cassibry, J.; Cortez, R.; Turner, M.; Percy, T.

    2011-01-01

    Fusion-based nuclear propulsion has the potential to enable fast interplanetary transportation. Due to the great distances between the planets of our solar system and the harmful radiation environment of interplanetary space, high specific impulse (Isp) propulsion in vehicles with high payload mass fractions must be developed to provide practical and safe vehicles for human spaceflight missions. The Z-Pinch dense plasma focus method is a Magneto-Inertial Fusion (MIF) approach that may potentially lead to a small, low cost fusion reactor/engine assembly1. Recent advancements in experimental and theoretical understanding of this concept suggest favorable scaling of fusion power output yield 2. The magnetic field resulting from the large current compresses the plasma to fusion conditions, and this process can be pulsed over short timescales (10(exp -6 sec). This type of plasma formation is widely used in the field of Nuclear Weapons Effects testing in the defense industry, as well as in fusion energy research. A Decade Module 2 (DM2), approx.500 KJ pulsed-power is coming to the RSA Aerophysics Lab managed by UAHuntsville in January, 2012. A Z-Pinch propulsion concept was designed for a vehicle based on a previous fusion vehicle study called "Human Outer Planet Exploration" (HOPE), which used Magnetized Target Fusion (MTF) 3 propulsion. The reference mission is the transport of crew and cargo to Mars and back, with a reusable vehicle.

  4. Socio-economic Aspects of Fusion

    SciTech Connect

    J.A. Schmidt

    2004-10-21

    Fusion power systems, if developed and deployed, would have many attractive features including power production not dependant on weather or solar conditions, flexible siting, and minimal carbon dioxide production. In this paper, we quantify the benefit of these features. In addition, fusion deployment scenarios are developed for the last half of this century and these scenarios are analyzed for resource requirements and waste production.

  5. The social evolution of somatic fusion.

    PubMed

    Aanen, Duur K; Debets, Alfons J M; de Visser, J Arjan G M; Hoekstra, Rolf F

    2008-11-01

    The widespread potential for somatic fusion among different conspecific multicellular individuals suggests that such fusion is adaptive. However, because recognition of non-kin (allorecognition) usually leads to a rejection response, successful somatic fusion is limited to close kin. This is consistent with kin-selection theory, which predicts that the potential cost of fusion and the potential for somatic parasitism decrease with increasing relatedness. Paradoxically, however, Crozier found that, in the short term, positive-frequency-dependent selection eliminates the required genetic polymorphism at allorecognition loci. The 'Crozier paradox' may be solved if allorecognition is based on extrinsically balanced polymorphisms, for example at immune loci. Alternatively, the assumption of most models that self fusion is mutually beneficial is wrong. If fusion is on average harmful, selection will promote unconditional rejection. However, we propose that fusion within individuals is beneficial, selecting for the ability to fuse, but fusion between individuals on average costly, selecting for non-self recognition (rather than non-kin recognition). We discuss experimental data on fungi that are consistent with this hypothesis. PMID:18937373

  6. Fusion breeder: its potential role and prospects

    SciTech Connect

    Lee, J.D.

    1981-01-01

    The fusion breeder is a concept that utilizes 14 MeV neutrons from D + T ..-->.. n(14.1 MeV) + ..cap alpha..(3.5 MeV) fusion reactions to produce more fuel than the tritium (T) needed to sustain the fusion process. This excess fuel production capacity is used to produce fissile material (Pu-239 or U-233) for subsequent use in fission reactors. We are concentrating on a class of blankets we call fission suppressed. The blanket is the region surrounding the fusion plasma in which fusion neutrons interact to produce fuel and heat. The fission-suppressed blanket uses non-fission reactions (mainly (n,2n) or (n,n't)) to generate excess neutrons for the production of net fuel. This is in contrast to the fast fission class of blankets which use (n,fiss) reactions to generate excess neutrons. Fusion reactors with fast fission blankets are commony known as fusion-fission hybrids because they combine fusion and fission in the same device.

  7. [La(3+)-induced fusion of plant protoplasts].

    PubMed

    Sheremet'ev, Iu A; Smirnova, D V; Sheremet'eva, A V

    2009-01-01

    The effect of La(3+) on the fusion of plant protoplasts has been studied. It was shown that La(3+) induced the aggregation of plant protoplasts. The incubation of a suspension of aggregated protoplasts at 42 degrees C for 30 min resulted in their fusion.

  8. National Ignition Facility for Inertial Confinement Fusion

    SciTech Connect

    Paisner, J.A.; Murray, J.R.

    1997-10-08

    The National Ignition Facility for inertial confinement fusion will contain a 1.8 MJ, 500 TW frequency-tripled neodymium glass laser system that will be used to explore fusion ignition and other problems in the physics of high temperature and density. We describe the facility briefly. The NIF is scheduled to be completed in 2003.

  9. Fluidized wall for protecting fusion chamber walls

    SciTech Connect

    Maniscalco, J.A.; Meier, W.R.

    1982-08-17

    Apparatus for protecting the inner wall of a fusion chamber from microexplosion debris, x-rays, neutrons, etc. Produced by deuterium-tritium (DT) targets imploded within the fusion chamber. The apparatus utilizes a fluidized wall similar to a waterfall comprising liquid lithium or solid pellets of lithiumceramic, the waterfall forming a blanket to prevent damage of the structural materials of the chamber.

  10. The importance of loading the periphery of the vertebral endplate

    PubMed Central

    Sutterlin, Chester; Dabirrahmani, Danè; Appleyard, Richard

    2016-01-01

    Background Commercial fusion cages typically provide support in the central region of the endplate, failing to utilize the increased compressive strength around the periphery. This study demonstrates the increase in compressive strength that can be achieved if the bony periphery of the endplate is loaded. Methods Sixteen cadaveric lumbar vertebrae (L1–L5) were randomly divided into two even groups. A different commercial mass produced implant (MPI) was allocated to each group: (I) a Polyether-ether-ketone (PEEK) anterior lumber inter-body fusion (ALIF) MPI; and (II) a titanium ALIF MPI. Uniaxial compression at a displacement rate of 0.5 mm/sec was applied to all vertebrae during two phases: (I) with the allocated MPI situated in the central region of the endplate; (II) with an aluminum plate, designed to load the bony periphery of the endplate. The failure load and mode of failure was recorded. Results From phase 1 to phase 2, the failure load increased from 1.1±0.4 to 2.9±1.4 kN for group 1; and from 1.3±1.0 to 3.0±1.9 kN for group 2. The increase in strength from phase 1 to phase 2 was statistically significant for each group (group 1: P<0.01, group 2: P<0.05, paired t-test). There was no significant difference between the groups in either phase (P>0.05, t-test). The mode of failure in phase 1 was the implant being forced through the endplate for both groups. In phase 2, the mode of failure was either a fracture of the epiphyseal rim or buckling of the side wall of the vertebral body. Conclusions Loading the periphery of the vertebral endplate achieved significant increase in compressive load capacity compared to loading the central region of the endplate. Clinically, this implies that patient-specific implants which load the periphery of the vertebral endplate could decrease the incidence of subsidence and improve surgical outcomes. PMID:27757430

  11. Fusion research: the past is prologue

    SciTech Connect

    Post, R F

    1998-10-14

    At this juncture fusion research can be viewed as being at a turning point, a time to review its past and to imagine its future. Today, almost 50 years since the first serious attempts to address the daunting problem of achieving controlled fusion, we have both an opportunity and a challenge. Some predictions place fusion research today at a point midway between its first inception and its eventual maturation - in the middle of the 21st century - when fusion would become a major source of energy. Our opportunity therefore is to assess what we have learned from 50 years of hard work and use that knowledge as a starting point for new and better approaches to solving the fusion problem. Our challenge is to prove the "50 more years" prophesy wrong, by finding ways to shorten the time when fusion power becomes a reality. The thesis will be advanced that in the magnetic confinement approach to fusion open-ended magnetic confinement geometries offer much in responding to the challenge. A major advantage of open systems is that, owing to their theoretically and experimentally demonstrated ability to suppress plasma instabilities of both the MHD and the high-frequency wave-particle variety, the confinement becomes predictable from "classical," i.e., Fokker-Planck-type analysis. In a time of straitened budgetary circumstances for magnetic fusion research now being faced in the United States, the theoretical tractability of mirror-based systems is a substantial asset. In pursuing this avenue it is also necessary to keep an open mind as to the forms that mirror-based fusion power plants might take. For example, one can look to the high-energy physics community for a possible model: This community has shown the feasibility of constructing large and complex particle accelerators using superconducting magnets, vacuum chambers and complicated particle-handling technology, housed in underground tunnels that are 20 or more kilometers long. In the paper examples of mirror

  12. The fusion diagnostic gamma experiment: A high-bandwidth fusion diagnostic of the National Ignition Facility

    SciTech Connect

    Moran, M.J.

    1999-01-01

    Diagnostics for the National Ignition Facility/inertial confinement fusion program must include good characterization of the fusion source. Ideally, diagnostics would measure the spatially resolved history of the fusion reaction rate and temperature. Existing diagnostics can satisfy this goal only partially. One class of new techniques that could play a major role in high-yield diagnostics is measurements based on fusion {gamma} rays. The fusion diagnostic gamma experiment can perform energy-resolved measurements of (D,T) fusion reaction rates. This diagnostic is based on the 16.7 MeV {gamma} rays that are produced by (D,T) fusion. The {gamma} rays are free of spectral dispersion and can be detected (via Compton recoil electrons) with a high bandwidth Cherenkov detector. A simple magnetic monochromator selects signals from the 16.7 MeV {gamma} rays and reduces background signals from nonfusion {gamma} rays. {copyright} {ital 1998 American Institute of Physics.}

  13. Estimating the melting point, entropy of fusion, and enthalpy of fusion of organic compounds via SPARC.

    PubMed

    Whiteside, T S; Hilal, S H; Brenner, A; Carreira, L A

    2016-08-01

    The entropy of fusion, enthalpy of fusion, and melting point of organic compounds can be estimated through three models developed using the SPARC (SPARC Performs Automated Reasoning in Chemistry) platform. The entropy of fusion is modelled through a combination of interaction terms and physical descriptors. The enthalpy of fusion is modelled as a function of the entropy of fusion, boiling point, and flexibility of the molecule. The melting point model is the enthalpy of fusion divided by the entropy of fusion. These models were developed in part to improve SPARC's vapour pressure and solubility models. These models have been tested on 904 unique compounds. The entropy model has a RMS of 12.5 J mol(-1) K(-1). The enthalpy model has a RMS of 4.87 kJ mol(-1). The melting point model has a RMS of 54.4°C. PMID:27586365

  14. Estimating the melting point, entropy of fusion, and enthalpy of fusion of organic compounds via SPARC.

    PubMed

    Whiteside, T S; Hilal, S H; Brenner, A; Carreira, L A

    2016-08-01

    The entropy of fusion, enthalpy of fusion, and melting point of organic compounds can be estimated through three models developed using the SPARC (SPARC Performs Automated Reasoning in Chemistry) platform. The entropy of fusion is modelled through a combination of interaction terms and physical descriptors. The enthalpy of fusion is modelled as a function of the entropy of fusion, boiling point, and flexibility of the molecule. The melting point model is the enthalpy of fusion divided by the entropy of fusion. These models were developed in part to improve SPARC's vapour pressure and solubility models. These models have been tested on 904 unique compounds. The entropy model has a RMS of 12.5 J mol(-1) K(-1). The enthalpy model has a RMS of 4.87 kJ mol(-1). The melting point model has a RMS of 54.4°C.

  15. Inertial-confinement fusion with lasers

    DOE PAGESBeta

    Betti, R.; Hurricane, O. A.

    2016-05-03

    The quest for controlled fusion energy has been ongoing for over a half century. The demonstration of ignition and energy gain from thermonuclear fuels in the laboratory has been a major goal of fusion research for decades. Thermonuclear ignition is widely considered a milestone in the development of fusion energy, as well as a major scientific achievement with important applications to national security and basic sciences. The U.S. is arguably the world leader in the inertial con fment approach to fusion and has invested in large facilities to pursue it with the objective of establishing the science related to themore » safety and reliability of the stockpile of nuclear weapons. Even though significant progress has been made in recent years, major challenges still remain in the quest for thermonuclear ignition via laser fusion.« less

  16. Feature fusion based on Wootters metric

    NASA Astrophysics Data System (ADS)

    Peng, Weimin; Chen, Aihong; Gong, Zhaozhe

    2016-10-01

    For further enhancing the completeness and conciseness of the existing quantum-inspired feature fusion methods, this paper applies the quantum-related theories of Wootters metric and Fisher linear discriminant to dimension reduction and feature fusion. From the perspective of quantum metric spaces, i.e. phase space and probability space, this paper proposes two different feature fusion methods which take the Wootters statistical distance as the key factor to detect and fuse the duplicate feature data, and are different to the already developed quantum-inspired feature fusion methods. The experimental results reflect the superiority of the proposed feature fusion methods based on the Wootters metric for their better performances on relative completeness and conciseness.

  17. Cancer Cell Fusion: Mechanisms Slowly Unravel

    PubMed Central

    Noubissi, Felicite K.; Ogle, Brenda M.

    2016-01-01

    Although molecular mechanisms and signaling pathways driving invasion and metastasis have been studied for many years, the origin of the population of metastatic cells within the primary tumor is still not well understood. About a century ago, Aichel proposed that cancer cell fusion was a mechanism of cancer metastasis. This hypothesis gained some support over the years, and recently became the focus of many studies that revealed increasing evidence pointing to the possibility that cancer cell fusion probably gives rise to the metastatic phenotype by generating widespread genetic and epigenetic diversity, leading to the emergence of critical populations needed to evolve resistance to the treatment and development of metastasis. In this review, we will discuss the clinical relevance of cancer cell fusion, describe emerging mechanisms of cancer cell fusion, address why inhibiting cancer cell fusion could represent a critical line of attack to limit drug resistance and to prevent metastasis, and suggest one new modality for doing so. PMID:27657058

  18. Laser-fusion rocket for interplanetary propulsion

    SciTech Connect

    Hyde, R.A.

    1983-09-27

    A rocket powered by fusion microexplosions is well suited for quick interplanetary travel. Fusion pellets are sequentially injected into a magnetic thrust chamber. There, focused energy from a fusion Driver is used to implode and ignite them. Upon exploding, the plasma debris expands into the surrounding magnetic field and is redirected by it, producing thrust. This paper discusses the desired features and operation of the fusion pellet, its Driver, and magnetic thrust chamber. A rocket design is presented which uses slightly tritium-enriched deuterium as the fusion fuel, a high temperature KrF laser as the Driver, and a thrust chamber consisting of a single superconducting current loop protected from the pellet by a radiation shield. This rocket can be operated with a power-to-mass ratio of 110 W gm/sup -1/, which permits missions ranging from occasional 9 day VIP service to Mars, to routine 1 year, 1500 ton, Plutonian cargo runs.

  19. A Reliability-Based Track Fusion Algorithm

    PubMed Central

    Xu, Li; Pan, Liqiang; Jin, Shuilin; Liu, Haibo; Yin, Guisheng

    2015-01-01

    The common track fusion algorithms in multi-sensor systems have some defects, such as serious imbalances between accuracy and computational cost, the same treatment of all the sensor information regardless of their quality, high fusion errors at inflection points. To address these defects, a track fusion algorithm based on the reliability (TFR) is presented in multi-sensor and multi-target environments. To improve the information quality, outliers in the local tracks are eliminated at first. Then the reliability of local tracks is calculated, and the local tracks with high reliability are chosen for the state estimation fusion. In contrast to the existing methods, TFR reduces high fusion errors at the inflection points of system tracks, and obtains a high accuracy with less computational cost. Simulation results verify the effectiveness and the superiority of the algorithm in dense sensor environments. PMID:25950174

  20. Magnetic-fusion energy and computers

    SciTech Connect

    Killeen, J.

    1982-01-01

    The application of computers to magnetic fusion energy research is essential. In the last several years the use of computers in the numerical modeling of fusion systems has increased substantially. There are several categories of computer models used to study the physics of magnetically confined plasmas. A comparable number of types of models for engineering studies are also in use. To meet the needs of the fusion program, the National Magnetic Fusion Energy Computer Center has been established at the Lawrence Livermore National Laboratory. A large central computing facility is linked to smaller computer centers at each of the major MFE laboratories by a communication network. In addition to providing cost effective computing services, the NMFECC environment stimulates collaboration and the sharing of computer codes among the various fusion research groups.

  1. Fusion-protein-assisted protein crystallization.

    PubMed

    Kobe, Bostjan; Ve, Thomas; Williams, Simon J

    2015-07-01

    Fusion proteins can be used directly in protein crystallization to assist crystallization in at least two different ways. In one approach, the `heterologous fusion-protein approach', the fusion partner can provide additional surface area to promote crystal contact formation. In another approach, the `fusion of interacting proteins approach', protein assemblies can be stabilized by covalently linking the interacting partners. The linker connecting the proteins plays different roles in the two applications: in the first approach a rigid linker is required to reduce conformational heterogeneity; in the second, conversely, a flexible linker is required that allows the native interaction between the fused proteins. The two approaches can also be combined. The recent applications of fusion-protein technology in protein crystallization from the work of our own and other laboratories are briefly reviewed.

  2. INTRODUCTION: Status report on fusion research

    NASA Astrophysics Data System (ADS)

    Burkart, Werner

    2005-10-01

    A major milestone on the path to fusion energy was reached in June 2005 on the occasion of the signing of the joint declaration of all parties to the ITER negotiations, agreeing on future arrangements and on the construction site at Cadarache in France. The International Atomic Energy Agency has been promoting fusion activities since the late 1950s; it took over the auspices of the ITER Conceptual Design Activities in 1988, and of the ITER Engineering and Design Activities in 1992. The Agency continues its support to Member States through the organization of consultancies, workshops and technical meetings, the most prominent being the series of International Fusion Energy Conferences (formerly called the International Conference on Plasma Physics and Controlled Nuclear Fusion Research). The meetings serve as a platform for experts from all Member States to have open discussions on their latest accomplishments as well as on their problems and eventual solutions. The papers presented at the meetings and conferences are routinely published, many being sent to the journal it Nuclear Fusion, co-published monthly by Institute of Physics Publishing, Bristol, UK. The journal's reputation is reflected in the fact that it is a world-renowned publication, and the International Fusion Research Council has used it for the publication of a Status Report on Controlled Thermonuclear Fusion in 1978 and 1990. This present report marks the conclusion of the preparatory phases of ITER activities. It provides background information on the progress of fusion research within the last 15 years. The International Fusion Research Council (IFRC), which initiated the report, was fully aware of the complexities of including all scientific results in just one paper, and so decided to provide an overview and extensive references for the interested reader who need not necessarily be a fusion specialist. Professor Predhiman K. Kaw, Chairman, prepared the report on behalf of the IFRC, reflecting

  3. A reliability-based track fusion algorithm.

    PubMed

    Xu, Li; Pan, Liqiang; Jin, Shuilin; Liu, Haibo; Yin, Guisheng

    2015-01-01

    The common track fusion algorithms in multi-sensor systems have some defects, such as serious imbalances between accuracy and computational cost, the same treatment of all the sensor information regardless of their quality, high fusion errors at inflection points. To address these defects, a track fusion algorithm based on the reliability (TFR) is presented in multi-sensor and multi-target environments. To improve the information quality, outliers in the local tracks are eliminated at first. Then the reliability of local tracks is calculated, and the local tracks with high reliability are chosen for the state estimation fusion. In contrast to the existing methods, TFR reduces high fusion errors at the inflection points of system tracks, and obtains a high accuracy with less computational cost. Simulation results verify the effectiveness and the superiority of the algorithm in dense sensor environments.

  4. Mirror Fusion Test Facility magnet system

    SciTech Connect

    VanSant, J.H.; Kozman, T.A.; Bulmer, R.H.; Ng, D.S.

    1981-09-11

    In 1979, R.H. Bulmer of Lawrence Livermore National Laboratory (LLNL) discussed a proposed tandem-mirror magnet system for the Mirror Fusion Test Facility (MFTF) at the 8th symposium on Engineering Problems in Fusion Research. Since then, Congress has voted funds for expanding LLNL's MFTF to a tandem-mirror facility (designated MFTF-B). The new facility, scheduled for completion by 1985, will seek to achieve two goals: (1) Energy break-even capability (Q or the ratio of fusion energy to plasma heating energy = 1) of mirror fusion, (2) Engineering feasibility of reactor-scale machines. Briefly stated, 22 superconducting magnets contained in a 11-m-diam by 65-m-long vacuum vessel will confine a fusion plasma fueled by 80 axial streaming-plasma guns and over 40 radial neutral beams. We have already completed a preliminary design of this magnet system.

  5. Economic potential of magnetic fusion energy

    SciTech Connect

    Henning, C.D.

    1981-03-10

    Scientific feasibility of magnetic fusion is no longer seriously in doubt. Rapid advances have been made in both tokamak and mirror research, leading to a demonstration in the TFTR tokamak at Princeton in 1982 and the tandem mirror MFTF-B at Livermore in 1985. Accordingly, the basis is established for an aggressive engineering thrust to develop a reactor within this century. However, care must be taken to guide the fusion program towards an economically and environmentally viable goal. While the fusion fuels are essentially free, capital costs of reactors appear to be at least as large as current power plants. Accordingly, the price of electricity will not decline, and capital availability for reactor constructions will be important. Details of reactor cost projections are discussed and mechanisms suggested for fusion power implementation. Also discussed are some environmental and safety aspects of magnetic fusion.

  6. Public Relations on Fusion in Europe

    NASA Astrophysics Data System (ADS)

    Ongena, J.; van Oost, G.; Paris, P. J.

    2000-10-01

    A summary will be presented of PR efforts on fusion energy research in Europe. A 3-D movie of a fusion research experimental reactor has been realized at the start of this year. It has been made entirely on virtual animation basis. Two versions exists, a short version of 3 min., as a video clip, and a longer version of nearly 8 min. Both could be viewed in 3D, using special projections and passive glasses or in normal VHS video projections. A new CD-ROM for individual and classroom use will be presented, discussing (i) the different energy forms, (ii) general principles of fusion, (iii) current research efforts and (iv) future prospects of fusion. This CD-ROM is now produced in English, German, French, Spanish, Italian and Portuguese Several new brochures and leaflets intended to increase the public awareness on fusion in Europe will be on display.

  7. Magneized target fusion: An overview of the concept

    SciTech Connect

    Kirkpatrick, R.C.

    1994-12-31

    Magnetized target fusion (MTF) seeks to take advantage of the reduction of thermal conductivity through the application of a strong magneticfield and thereby ease the requirements for reaching fusion conditions in a thermonuclear (TN) fusion fuel. A potentially important benefit of the strong field in the partial trapping of energetic charged particles to enhance energy deposition by the TN fusion reaction products. The essential physics is described. MTF appears to lead to fusion targets that require orders of magnitude less power and intensity for fusion ignition than currently proposed (unmagnetized) inertial confinement fusion (ICF) targets do, making some very energetic pulsed power drivers attractive for realizing controlled fusion.

  8. Passive-sensor data fusion

    NASA Astrophysics Data System (ADS)

    Kolitz, Stephan E.

    1991-08-01

    Problems in multi-sensor data fusion are addressed for passive (angle-only) sensors; the example used is a constellation of IR sensors on satellites in low-earth orbit, viewing up to several hundred ballistic missile targets. The sensor data used in the methodology of the report is 'post-detection,' with targets resolved on single pixels (it is possible for several targets to be resolved on the same pixel). A 'scan' by a sensor is modeled by the formation of a rectangular focal plane image of lit pixels (bits with value 1), representing the presence of at least one target, and unlit pixels (bits with value 0), representing the absence of a target, at a particular time. Approaches and algorithmic solutions are developed which address the following passive sensor data fusion problems: scan-to-scan target association, and association classification. The ultimate objective is to estimate target states, for use in a larger battle management system. Results indicate that successful scan-to-scan target association is feasible at scan rates >=2 Hz, independent of resolution. Sensor-to-sensor target association is difficult at low resolution; even with high-resolution sensors the performance of a standard two-sensor single scan approach is variable and unpredictable, since it is a function of the relative geometry of sensors and targets. A single-scan approach using the Varad algorithm and three sensors is not as sensitive to this relative geometry, but is usable only for high-resolution sensors. Innovative multi-scan and multi-sensor modifications of the three- sensor Varad algorithm are developed which provide excellent performance for a wide range of sensor resolutions. The multi-sensor multi-scan methodology also provides accurate information on the classification of target associations as correct or incorrect. For the scenarios examined with resolution cell sizes ranging from 300 m to 2 km, association errors are less than 5% and essentially no classification errors

  9. INTRODUCTION: Status report on fusion research

    NASA Astrophysics Data System (ADS)

    Burkart, Werner

    2005-10-01

    A major milestone on the path to fusion energy was reached in June 2005 on the occasion of the signing of the joint declaration of all parties to the ITER negotiations, agreeing on future arrangements and on the construction site at Cadarache in France. The International Atomic Energy Agency has been promoting fusion activities since the late 1950s; it took over the auspices of the ITER Conceptual Design Activities in 1988, and of the ITER Engineering and Design Activities in 1992. The Agency continues its support to Member States through the organization of consultancies, workshops and technical meetings, the most prominent being the series of International Fusion Energy Conferences (formerly called the International Conference on Plasma Physics and Controlled Nuclear Fusion Research). The meetings serve as a platform for experts from all Member States to have open discussions on their latest accomplishments as well as on their problems and eventual solutions. The papers presented at the meetings and conferences are routinely published, many being sent to the journal it Nuclear Fusion, co-published monthly by Institute of Physics Publishing, Bristol, UK. The journal's reputation is reflected in the fact that it is a world-renowned publication, and the International Fusion Research Council has used it for the publication of a Status Report on Controlled Thermonuclear Fusion in 1978 and 1990. This present report marks the conclusion of the preparatory phases of ITER activities. It provides background information on the progress of fusion research within the last 15 years. The International Fusion Research Council (IFRC), which initiated the report, was fully aware of the complexities of including all scientific results in just one paper, and so decided to provide an overview and extensive references for the interested reader who need not necessarily be a fusion specialist. Professor Predhiman K. Kaw, Chairman, prepared the report on behalf of the IFRC, reflecting

  10. Ion Rings for Magnetic Fusion

    SciTech Connect

    Greenly, John, B.

    2005-07-31

    This Final Technical Report presents the results of the program, Ion Rings for Magnetic Fusion, which was carried out under Department of Energy funding during the period August, 1993 to January, 2005. The central objective of the program was to study the properties of field-reversed configurations formed by ion rings. In order to reach this objective, our experimental program, called the Field-reversed Ion Ring Experiment, FIREX, undertook to develop an efficient, economical technology for the production of field-reversed ion rings. A field-reversed configuration (FRC) in which the azimuthal (field-reversing) current is carried by ions with gyro-radius comparable to the magnetic separatrix radius is called a field-reversed ion ring. A background plasma is required for charge neutralization of the ring, and this plasma will be confined within the ring's closed magnetic flux. Ion rings have long been of interest as the basis of compact magnetic fusion reactors, as the basis for a high-power accelerator for an inertial fusion driver, and for other applications of high power ion beams or plasmas of high energy density. Specifically, the FIREX program was intended to address the longstanding question of the contribution of large-orbit ions to the observed stability of experimental FRCs to the MHD tilt mode. Typical experimental FRCs with s {approx} 2-4, where s is the ratio of separatrix radius to ion gyro-radius, have been stable to tilting, but desired values for a fusion reactor, s > 20, should be unstable. The FIREX ring would consist of a plasma with large s for the background ions, but with s {approx} 1 for the ring ions. By varying the proportions of these two populations, the minimum proportion of large-orbit ions necessary for stability could be determined. The incorporation of large-orbit ions, perhaps by neutral-beam injection, into an FRC has been advanced for the purpose of stabilizing, heating, controlling angular momentum, and aiding the formation of a

  11. Magnetic systems for fusion devices

    SciTech Connect

    Henning, C.D.

    1985-02-01

    Mirror experiments have led the way in applying superconductivity to fusion research because of unique requirements for high and steady magnetic fields. The first significant applications were Baseball II at LLNL and IMP at ORNL. More recently, the MFTF-B yin-yang coil was successfully tested and the entire tandem configuration is nearing completion. Tokamak magnets have also enjoyed recent success with the large coil project tests at ORNL, preceded by single coil tests in Japan and Germany. In the USSR, the T-7 Tokamak has been operational for many years and the T-15 Tokamak is under construction, with the TF coils nearing completion. Also the Tore Supra is being built in France.

  12. Laser-driven fusion reactor

    DOEpatents

    Hedstrom, J.C.

    1973-10-01

    A laser-driven fusion reactor consisting of concentric spherical vessels in which the thermonuclear energy is derived from a deuterium-tritium (D + T) burn within a pellet'', located at the center of the vessels and initiated by a laser pulse. The resulting alpha -particle energy and a small fraction of the neutron energy are deposited within the pellet; this pellet energy is eventually transformed into sensible heat of lithium in a condenser outside the vessels. The remaining neutron energy is dissipated in a lithium blanket, located within the concentric vessels, where the fuel ingredient, tritium, is also produced. The heat content of the blanket and of the condenser lithium is eventually transferred to a conventional thermodynamic plant where the thermal energy is converted to electrical energy in a steam Rankine cycle. (Official Gazette)

  13. Status of cold fusion (2010).

    PubMed

    Storms, Edmund

    2010-10-01

    The phenomenon called cold fusion has been studied for the last 21 years since its discovery by Profs. Fleischmann and Pons in 1989. The discovery was met with considerable skepticism, but supporting evidence has accumulated, plausible theories have been suggested, and research is continuing in at least eight countries. This paper provides a brief overview of the major discoveries and some of the attempts at an explanation. The evidence supports the claim that a nuclear reaction between deuterons to produce helium can occur in special materials without application of high energy. This reaction is found to produce clean energy at potentially useful levels without the harmful byproducts normally associated with a nuclear process. Various requirements of a model are examined.

  14. Multishell inertial confinement fusion target

    DOEpatents

    Holland, James R.; Del Vecchio, Robert M.

    1984-01-01

    A method of fabricating multishell fuel targets for inertial confinement fusion usage. Sacrificial hemispherical molds encapsulate a concentric fuel pellet which is positioned by fiber nets stretched tautly across each hemispherical mold section. The fiber ends of the net protrude outwardly beyond the mold surfaces. The joint between the sacrificial hemispheres is smoothed. A ceramic or glass cover is then deposited about the finished mold surfaces to produce an inner spherical surface having continuously smooth surface configuration. The sacrificial mold is removed by gaseous reaction accomplished through the porous ceramic cover prior to enclosing of the outer sphere by addition of an outer coating. The multishell target comprises the inner fuel pellet concentrically arranged within a surrounding coated cover or shell by fiber nets imbedded within the cover material.

  15. Multishell inertial confinement fusion target

    DOEpatents

    Holland, James R.; Del Vecchio, Robert M.

    1987-01-01

    A method of fabricating multishell fuel targets for inertial confinement fusion usage. Sacrificial hemispherical molds encapsulate a concentric fuel pellet which is positioned by fiber nets stretched tautly across each hemispherical mold section. The fiber ends of the net protrude outwardly beyond the mold surfaces. The joint between the sacrificial hemispheres is smoothed. A ceramic or glass cover is then deposited about the finished mold surfaces to produce an inner spherical surface having continuously smooth surface configuration. The sacrificial mold is removed by gaseous reactions accomplished through the porous ceramic cover prior to enclosing of the outer sphere by addition of an outer coating. The multishell target comprises the inner fuel pellet concentrically arranged within a surrounding coated cover or shell by fiber nets imbedded within the cover material.

  16. Inertial-confinement-fusion targets

    SciTech Connect

    Hendricks, C.D.

    1982-08-10

    Much of the research in laser fusion has been done using simple ball on-stalk targets filled with a deuterium-tritium mixture. The targets operated in the exploding pusher mode in which the laser energy was delivered in a very short time (approx. 100 ps or less) and was absorbed by the glass wall of the target. The high energy density in the glass literally exploded the shell with the inward moving glass compressing the DT fuel to high temperatures and moderate densities. Temperatures achieved were high enough to produce DT reactions and accompanying thermonuclear neutrons and alpha particles. The primary criteria imposed on the target builders were: (1) wall thickness, (2) sphere diameter, and (3) fuel in the sphere.

  17. Status of cold fusion (2010)

    NASA Astrophysics Data System (ADS)

    Storms, Edmund

    2010-10-01

    The phenomenon called cold fusion has been studied for the last 21 years since its discovery by Profs. Fleischmann and Pons in 1989. The discovery was met with considerable skepticism, but supporting evidence has accumulated, plausible theories have been suggested, and research is continuing in at least eight countries. This paper provides a brief overview of the major discoveries and some of the attempts at an explanation. The evidence supports the claim that a nuclear reaction between deuterons to produce helium can occur in special materials without application of high energy. This reaction is found to produce clean energy at potentially useful levels without the harmful byproducts normally associated with a nuclear process. Various requirements of a model are examined.

  18. Progress in Heavy Ion Fusion

    SciTech Connect

    Herrmannsfeldt, W.B.

    1988-09-01

    The progress of the field of Heavy Ion Fusion has been documented in the proceedings of the series of International Symposia that, in recent years, have occurred every second year. The latest of these conferences was hosted by Gesellshaft fuer Schwerionenforshung (GSI) in Darmstadt, West Germany, June 28-30, 1988. For this report, a few highlights from the conference are selected, stressing experimental progress and prospects for future advances. A little extra time is devoted to report on the developments at the Lawrence Berkeley Laboratory (LBL) which is the center for most of the HIFAR program. The Director of the HIFAR program at LBL is Denis Keefe, who presented the HIF report at the last two of the meetings in this series, and in whose place the author is appearing now. 4 refs., 1 fig.

  19. Differential cholesterol binding by class II fusion proteins determines membrane fusion properties.

    PubMed

    Umashankar, M; Sánchez-San Martín, Claudia; Liao, Maofu; Reilly, Brigid; Guo, Alice; Taylor, Gwen; Kielian, Margaret

    2008-09-01

    The class II fusion proteins of the alphaviruses and flaviviruses mediate virus infection by driving the fusion of the virus membrane with that of the cell. These fusion proteins are triggered by low pH, and their structures are strikingly similar in both the prefusion dimer and the postfusion homotrimer conformations. Here we have compared cholesterol interactions during membrane fusion by these two groups of viruses. Using cholesterol-depleted insect cells, we showed that fusion and infection by the alphaviruses Semliki Forest virus (SFV) and Sindbis virus were strongly promoted by cholesterol, with similar sterol dependence in laboratory and field isolates and in viruses passaged in tissue culture. The E1 fusion protein from SFV bound cholesterol, as detected by labeling with photocholesterol and by cholesterol extraction studies. In contrast, fusion and infection by numerous strains of the flavivirus dengue virus (DV) and by yellow fever virus 17D were cholesterol independent, and the DV fusion protein did not show significant cholesterol binding. SFV E1 is the first virus fusion protein demonstrated to directly bind cholesterol. Taken together, our results reveal important functional differences conferred by the cholesterol-binding properties of class II fusion proteins.

  20. In vitro fusion of Acanthamoeba phagolysosomes. I. Demonstration and quantitation of vacuole fusion in Acanthamoeba homogenates.

    PubMed

    Oates, P J; Touster, O

    1976-02-01

    Fusion of phagolysosomes (PLs) has been demonstrated to occur in vitro. Two separate cell homogenates of the ameba Acanthamoeba sp. (Neff) were prepared, each rich in PLs labeled with distinctive particulate markers. Portions of each were incubated together in vitro and fusion occurred as evidenced by the appearance of PLs containing both types of markers. Fusion was confirmed by electron microscopy, including serial sectioning. The membranes of fused vacuoles excluded the dye eosin Y. Surviving cells in the homogenates were not responsible for the observed fusion. Fusion was obtained using either synthetic markers (polystyrene and polyvinyltoluene latex) or biological markers (autoclaved yeast cells and glutaraldehyde-fixed goat red blood cells), or a combination of both. The specificity of PL fusion in vivo appeared to be maintained in vitro. As determined by light and electron microscopy, the fusion reaction was dependent on time and temperature, and on the initial presence of membrane around both marker particles. A minimum of 10% of the vacuoles fused by 10 min of incubation at 30 degrees C, and no rupture of the vacuoles was detected during this time. After 10 min of incubation, vacuole rupture began and fusion ceased. At a constant initial vacuole concentration, the extent of PL fusion in vitro was quantitatively reproducible. This appears to be a promising system for further investigation of membrane fusion in the lysosomal system. PMID:1245550