The Comparison of Pedicle Screw and Cortical Screw in Posterior Lumbar Inter-body Fusion: a Prospective Randomized Non-inferiority Trial
|
|
- Duane Powers
- 5 years ago
- Views:
Transcription
1 Accepted Manuscript The Comparison of Pedicle Screw and Cortical Screw in Posterior Lumbar Inter-body Fusion: a Prospective Randomized Non-inferiority Trial Gun Woo Lee, MD, Jung-Hwan Son, MD, Myun-Whan Ahn, MD, Ho-Joong Kim, MD, Jin S. Yeom, MD PII: S-0()000- DOI: 0.0/j.spinee Reference: SPINEE To appear in: The Spine Journal Received Date: June 0 Revised Date: January 0 Accepted Date: February 0 Please cite this article as: Lee GW, Son J-H, Ahn M-W, Kim H-J, Yeom JS, The Comparison of Pedicle Screw and Cortical Screw in Posterior Lumbar Inter-body Fusion: a Prospective Randomized Noninferiority Trial, The Spine Journal (0), doi: 0.0/j.spinee This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
2 The Comparison of Pedicle Screw and Cortical Screw in Posterior Lumbar Interbody Fusion: a Prospective Randomized Non-inferiority Trial Gun Woo Lee, MD a,*, Jung-Hwan Son, MD b, Myun-Whan Ahn, MD c, Ho-Joong Kim, MD d, Jin S. Yeom, MD d a Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju, -, Republic of Korea b Department of Orthopaedic Surgery, Kosin University Gospel Hospital, Busan, Republic of Korea c Spine Centrer and Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Republic of Korea d Spine Centrer and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Sungnam, Korea * Corresponding author: Gun Woo Lee, MD Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yongam-ri, -, Eunhyeon-myeon, Yangju-si Gyeonggi-do, -, Republic of Korea Tel: --- address: gwlee@gmail.com
3 Running Head: Acknowledgements: none
4 Abstract Background Context: Pedicle screws (PS) offer great benefits in posterior lumbar inter- 0 0 body fusion (PLIF), but several drawbacks of PS, including the risk of superior facet joint violation and muscle injury, have also pointed out. Recently, cortical screws (CS) were invented, which can be placed without the drawbacks associated with PS. However, whether or not CS in PLIF can provide similar or greater clinical and radiological outcomes compared to those of PS has not been fully evaluated in clinical research studies. Purpose: To evaluate whether the CS provides similar results to the PS in PLIF, in terms of fusion rate, clinical and surgical outcomes, and complications. Study Design: Prospective, randomized, non-inferiority trial Patient Sample: Seventy-nine eligible patients were randomly assigned to either group A ( patients), for which PS was utilized, or group B (0 patients), for which CS was utilized. Outcome Measure: The primary study endpoint was to measure fusion rate using dynamic radiographs and CT scans. Secondary endpoints included intensity of lower back pain and pain radiating to the leg using visual analogue scales, and also, functional status using the Oswestry disability index, surgical morbidity, and additional outcomes such as pedicle fracture and mechanical failure. Methods: We compared baseline data in both groups. To evaluate the efficacy of CS in PLIF compared to PS, we compared fusion rates, clinical outcomes, and complications after surgery in both groups. No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
5 Results: At the six- and twelve-month follow-up points, similar fusion rates were observed in both groups (P = 0. and 0., respectively). According to the clinical 0 outcome, CS provided similar improvements in pain amelioration and functional status compared to PS, with no significant differences. Additionally, CS resulted in significantly less surgical morbidity, including shorter incision length, quicker operative time, and less blood loss, compared to PS. Conclusion: CS in PLIF provides similar clinical and radiological outcomes compared to PS in PLIF. Based on the current study, we suggest CS to be a reasonable alternative to PS in PLIF.
6 INTRODUCTION Posterior lumbar inter-body fusion (PLIF) surgery with pedicle screw (PS) has 0 0 recently been widely used as an effective surgical method for certain lumbar pathologies such as spondylolisthesis [-]. PS has been recognized as an irreplaceable instrument in fusion surgery of the lumbar spine due to its advantages [,-]. However, concerns regarding PS include the risk of superior facet joint violation during screw placement or dissection, the skin incision length, and the amount of lateral muscle dissection due to the entry point being lateral to the midline, near the lateral wall of facet joint. In spite of those drawbacks, there was little choice for spine surgeons but to utilize PS, resulting from the lack of alternatives. Recently, cortical screws (CS) using cortical screw trajectories in the lumbar spine were introduced for posterior stabilization [-]. Some experimental studies have demonstrated that CS provide similar strength as compared to PS [-]. Perez-Orribo et al. [] reported that the bilateral CS-rod fixation technique could provide similar stability in cadaveric experiments compared to PS-rod fixation, regardless of the presence of the inter-body cages. Because of their favorable entry point (near the pars articularis) and favorable passage (through the pedicle supero-laterally from the entry point), CS are expected to reduce the rate of facet joint violation, as well as to achieve better clinical and surgical outcomes. However, postoperative outcomes when using CS in PLIF have not been fully described.
7 To date, the therapeutic efficacy of CS in PLIF has yet to be fully described. Furthermore, to the best of our knowledge, outcomes using CS and PS for PLIF have no yet been compared in a prospective randomized study. Therefore, we analyzed and compared the clinical and radiological outcomes of CS and PS in PLIF, using a prospective, randomized design via a non-inferiority trial. We hypothesized that CS would result in comparable efficacy in terms of fusion rate, clinical, and surgical outcomes, in comparison with PS in PLIF.
8 METHODS Participants 0 0 This study was approved by the institutional review board. follows. Inclusion criteria were as First, patients were diagnosed with certain lumbar pathologies, including LSS with severe foraminal stenosis and isthmic spondylolisthesis, using lumbar spine radiographs, computed tomography (CT) scans, and magnetic resonance images (MRI) that corresponded to clinical manifestations and physical examinations. Second, patients were required to have shown no improvement in clinical symptoms despite several conservative treatments (including medication, physical therapy, and injection treatment) over a period of six months or more. Third, patients were required to have undergone PLIF at a single level using screws (PS or CS) and inter-body polyetheretherketone (PEEK) cages. Fourth, patients were between 0 and 0 years of age. Fifth, patients were volunteers for this study with their written consent. Finally, patients were required to complete a one year or longer follow-up period. Exclusion criteria were as follows: fractures, infection or tumors in the lumbar spine; osteoporosis diagnosed by a T-score less than -. on dual-energy X-ray absorptiometry (DEXA) bone densitometry measurements, multi-level fusion surgery, hemorrhagic disorders, such as hemophilia and thrombocythemia, patient inability to accurately complete preoperative and postoperative questionnaires, and lack of patient suitability for this study, as judged by the corresponding author. The inclusion and exclusion criteria were applied in order to avoid confounding effects on outcome variables.
9 Sample size estimation 0 0 This study was conducted to determine whether CS are a posterior stabilizer in PLIF surgery compared to PS based on the fusion rate and clinical outcomes. Thus, we used the non-inferiority criteria to calculate the appropriate sample size []. The primary endpoint was the fusion rate, and the expected fusion rate of the control group using PS (group A) was %, which is in agreement with several studies [-]. For noninferiority of CS versus PS in PLIF with a two-sided % significance level, a power of 0%, and a noninferiority margin of %, a sample size of patients for each group was necessary. Given an anticipated dropout rate of 0%, a total of patients were required. Randomization Patients were randomly assigned into group A, for which PS was utilized, or group B, for which CS was utilized. The group allocation (PS or CS screw type) was blinded to the patient, not to the surgeon and other health providers, meaning that this is single-blind study in regards to the patient. Randomization was conducted by a computer-generated allocation program (nqquery Advisor PPS.0, Saugus, MA, USA), which assigns numbers in strict chronological sequences and enters regular sequences for each study group. Randomization was stratified via three variables: () age (0s versus 0s), () smoking status (smoker versus non-smoker), and () operation level (L- versus L-S). Each study participant was allocated a unique randomization number upon screening completion.
10 Surgical procedures and postoperative protocols All surgeries were performed by a single orthopedic surgeon who used the same operative 0 0 technique for each surgery. In the surgeries, posterior decompression via partial laminectomy was performed following a posterior midline skin incision. When necessary, a partial or total facetectomy was also performed. In each patient, two PEEK cages (CAPSTONE, Medtronic, Memphis TN, USA) were routinely utilized for inter-body fusion with the auto-graft bone materials that were locally obtained during posterior decompression. To improve the fusion rate, mixtures of locally-harvested auto-graft bone and demineralized bone matrix (DBM, Korea Bone Bank, Seoul, Korea) were placed and packed around the cages. In group A, bilateral screw-rod systems with PS (CD Horizon Legacy system, Medtronic, Memphis TN, USA) were used under fluoroscopic guidance, and. x mm screws were utilized for each patient in group A. In group B, a bilateral screw-rod system with CS (MIDLF, Medtronic Sofamor Danek, Memphis TN, USA) was used under fluoroscopic guidance (Fig. ), and. x 0 mm screws in L and L and. x mm screws in S were utilized. Patients in both groups were admitted to the same wards following the operation and were then treated with the same postoperative protocols. All patients were permitted to ambulate the first day after surgery, and the majority of patients were discharged from the hospital on postoperative day fourteen. Patients were encouraged to avoid sitting for long periods of time during the first month following surgery. After three months post-surgery, patients were allowed to resume normal activities, including heavy lifting.
11 Outcome measures The primary post-surgery study endpoint was fusion rate. Fusion status was determined at 0 0 six and twelve months after surgery. Fusion was defined by the difference less than two degrees in Cobb angles in lateral radiographs taken in flexion and extension and by the presence of a continuous fusion mass either inside or outside the cage as seen on CT imaging. Non-union was declared if the difference in Cobb angle was greater than two degrees, or if the fusion mass on CT scans was discontinuous. An orthopedic spine surgeon, who was not involved in patient treatment, performed all dynamic radiography and CT measurements. Dynamic radiograph measurements were carried out using the picture archiving and communication system (PACS) program (Infinitt, Bracknell, Berkshire, UK). To mitigate measurement error, all dynamic radiograph measurements were performed according to several criteria. First, lateral flexion and extension radiographs were simultaneously viewed on dual monitors. Second, images were viewed at 00% magnification. Third, all radiographs were changed to the bone image setting for detailed evaluation of the bone. All CT scans were taken using.0-mm intervals (Mx000 IDT; Philips Medical System, Best, Netherlands). There were several secondary endpoints. Secondary endpoints included the intensity of lower back pain and pain radiating to the lower extremity (each measured separately using a visual analogue scale (VAS)), functional status (using the Oswestry disability index (ODI)), surgical morbidity (based on operating time, incision length, estimated blood loss, and hospital stay), and additional outcomes including infection rate or mechanical failure.
12 These data were collected prospectively by the corresponding author, both preoperatively and at each regular follow-up visit. Statistical analysis Independent Student s t-tests or analysis of variance (ANOVA) tests were used for continuous variables, and the Fisher s exact test was used for proportional variables. SPSS software version.0 (SPSS, Chicago, IL, USA) was used for all analyses. Twosided P-values < 0.0 were considered to be statistically significant.
13 RESULTS Patient characteristics 0 0 Seventy-nine eligible patients were randomly assigned to group A ( patients) and group B (0 patients). Of them, patients ( in group A and in group B) were qualified for the study, each of whom fully complied with the inclusion criteria (Fig. ). Patients were similar between groups with respect to demographic characteristics such as age, gender, smoking status, height, weight, BMI, and preoperative lumbar pathology (Table ). Primary outcome measure (fusion rate) According to the dynamic radiographs, fusion at six months post-surgery was achieved in / patients (.%) in group A, and in / patients (.%) in group B. The difference in fusion rate was not significant (P = 0.). At twelve months post-surgery, fusion was achieved in / patients (.%) in group A and in / patients (.%) in group B, which was not a significant difference (P = 0.) (Table ). On CT scan, fusion at six months post-surgery was achieved in / patients (.0%) in group A and in / patients (.%) in group B, which was not significantly different between groups (P = 0.). On one year after surgery, / patients (.%) in group A and / patients (.%) in group B achieved fusion, with no significant difference between groups (P = 0.) (Table ). Secondary outcome measures 0
14 Mean VAS scores for lower back pain indicated that one-year postoperative pain levels were significantly lower than preoperative levels for both groups, with mean scores 0 0 decreasing from. ±. preoperatively to.0 ±.0 at one postoperative year in group A, and from. ±. to. ±. in group B (P = 0.). These VAS scores were not significantly different between the two groups. However, the VAS scores for lower back pain at postoperative week one were significantly different between the groups at. ±. for group A and. ±. for group B (P = 0.0). VAS scores for radiating pain also improved significantly in both groups, with mean scores decreasing from. ±. preoperatively to. ± 0. at one postoperative year in group A, and from. ±. to. ± 0. in group B, but there were no significant differences between the groups (P = 0.) (Fig. and Table ). In addition, the mean ODI score also improved from. ± 0. preoperatively to.0 ±. one year after surgery in group A, and from. ±. preoperatively to 0. ±. one year after surgery in group B. These ODI scores were not significantly different between the two groups (P = 0.) (Fig. and Table ). Surgical morbidities, including blood loss, operation time, hospital stay, and incision length, are described in Table. Of which, group B was associated with better outcomes compared to group A, in terms of blood loss, operation time, and incision length (P = 0.0, 0.0, and 0.0, respectively). Facet joint violation as evalutaed on postoperative CT was occurred at / (%) in group A and 0/ (0%) in group B, which was significantly different between the groups (P < 0.0). Mechanical problems such as bony fracture at
15 the pars or pedicle due to screw placement, screw fracture, screw migration, and cage migration were not present in any patients of either group. On postoperative CT scan, malpositioned screws were seen in two in group A patients. No malpositioned screws were seen in group B. There were no complications such as fever, swelling, or deep infection for any patient. However, there was one instance of a local superficial infection at the surgical site in one of group A patient. The infection was resolved without complication after wound debridement.
16 DISCUSSION There were several principle findings of the current study. Similar fusion rates were 0 0 observed in both groups at six- and twelve-month follow-up, with no significant differences between the groups. Clinically, CS provided similar improvements in pain relief and functional status as compared to PS in PLIF. In addition, CS resulted in lower surgical morbidity measured by blood loss, operation time, and incision length, as compared to PS. Based on the current study, we suggest that using CS in PLIF could provide similar outcomes to PS at the one-year follow-up point, and thus, CS might be a reasonable alternative to PS in PLIF. Some experimental studies have demonstrated the ability of CS to provide sufficient strength to endure a similar level of stress compared to PS [-]. Perez-Orribo et al. [] also reported that the bilateral CS-rod fixation technique could provide similar stability in cadaveric experiments compared to PS-rod fixation, regardless of whether an inter-body device is present. However, whether CS could provide sufficient clinical outcomes and fusion rates without complications has not yet been fully evaluated in clinical research studies. Thus, we aimed to evaluate the fusion rate, clinical outcomes, and potential complications of CS in PLIF, and to compare these outcomes to PS in PLIF, using a prospective, randomized, non-inferiority design. In the current study, fusion rates were not significantly different between the two screw types. For example, the fusion rate at the first postoperative year was.% in group A versus.% in group B according to dynamic radiographs and.% in group A versus.% in group B according to CT scans
17 (P = 0. and 0., respectively). Radiologic complications such as loosened or pulled- out screw were not observed in any patients of both groups. Clinically, there was no 0 0 statistically significant difference between the two groups in improvement in pain intensity and ODI scores. However, in the immediate postoperative period, within one week of surgery, CS provided significantly better lower back pain scores compared to PS, which was caused by smaller skin incision and with less muscle dissection of CS, as described the surgical outcomes of the current study. PS has been recognized as an irreplaceable instrument in fusion surgery of the lumbar spine due to its advantages, such as its ability to produce sufficient stability to the destabilized lumbar segment and its ease of use and placement in the area [,-,0,], but some drawbacks to PS have been pointed out. One concern for PS is the risk of superior articulating facet violation during screw placement or dissection [,,,], and another is the need of long skin incision and significant muscle dissection due to the very lateral to midline entry point of PS, at the lateral wall of the pedicle. Previous studies revealed that superior facet joint violations were a common occurrence during PS placement, with an incidence of %-% in open surgery and %-00% in percutaneous surgery [,]. In the late 000s, CS using cortical screw trajectories was invented, such that screws could be placed without those drawbacks of PS [-,]. Due to the entry point of the CS being near the pars articularis, which is far from the superior facet joint, the risk of superior facet violation is much lower than in PS. The current study also showed that the facet joint violation occurred at % in group A and 0% in group B (P < 0.0). In addition, the CS entry point allows screw placement with a smaller skin incision and with less muscle
18 dissection and injury compared to PS, which were also demonstrated by outcomes of the current study. In addition, the risk of cortical bone violation of the pedicle or the pars 0 0 when using CS is less than when using PS because CS placement is made during the visualization of several landmarks. For example, the starting point is at the crosshairs of a line bisecting the pars interarticular, which is approximately 0 to mm below the superior facet joint capsule. Also, determination of the CS placement can be easily made under fluoroscopy. Moreover, there has been concern regarding the risk of bony fracture at the pars or pedicle due to CS placement because the angle of screw insertion is too steep and the CS screw length is shorter than PS, but no fracture was observed in the current study. The current study has some limitations. First, we did not conduct the current study with a sufficient sample size because this study was designed as a non-inferiority trial. There have not been reports of the outcomes of CS in PLIF, so we conducted this study as a preliminary clinical trial. Since the completion of this study, we have performed an additional comparative study between CS and PS in PLIF with a larger sample size and longer follow-up times. Second, this study had a short follow-up period of one year. To better establish the outcomes of CS in PLIF for LSS patients, further studies should be performed using a larger sample size, an extended follow-up period, and a prospective study design. Third, this study was conducted on patients without osteoporosis, as seen on DEXA scan, who underwent single-level PLIF surgery in the L- or L-S segments. In other words, the results of this study cannot be applied to subjects having multilevel fusion surgeries, surgeries on other lumbar segments, or those with osteoporotic bone. Fourth,
19 because this study was conducted in limited population, mainly males between the ages of 0-0 years, statistical analysis may be complicated due to the inherent non-normal 0 distribution, and our conclusions might not be acceptable for all patient populations. Thus, further studies should be performed with patients of a broader age range and with both sexes. Finally, this study was not blinded to the surgeons, assessors for evaluating the radiologic images, and other health care providers due to the nature of the study type, which might produce the performance bias. Despite these limitations, the current study has some unique strengths. Because our hospital is an armed force hospital, follow-up visits for each enrolled patient were possible. Also, this is the first clinical research study with a prospective-randomized design to evaluate CS outcomes in PLIF. Moreover, the data in the current study were obtained from a homogenous population with respect to physical activity, since the research was performed at an armed forces hospital. Such population homogeneity reduces the risk of confounding factors on outcome variables. Due to a paucity of articles regarding the efficacy of CS in PLIF, hopefully this study can serve as a baseline for further research on CS.
20 CONCLUSION The current study was conducted to evaluate the efficacy of CS compared to PS in PLIF 0 one year after surgery using a prospective, randomized, non-inferiority design. There was no significant difference in fusion rate between CS and PS, which was the primary endpoint. In addition, there was no statistically significant difference in clinical outcomes, based on pain intensity and ODI status, between CS and PS use. Moreover, CS in PLIF resulted in less facet joint violation and surgical morbidity than PS. Based on these results, we suggest that the CS would provide similar outcomes compared to PS in PLIF at one year after surgery, and thus, CS is a reasonable alternative to PS in PLIF. Additional studies should be performed with larger sample sizes, extended follow-up periods, and with prospective-randomized designs to better understand the clinical and radiological outcomes of these two screws.
21 Funding No funds were received in support of the present work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
22 References [] Szpalski M, Gunzburg R. Lumbar spinal stenosis in the elderly: an overview. Eur 0 Spine J 00;:S0. [] Abbas J, Hamoud K, May H, et al. Socioeconomic and Physical Characteristics of Individuals With Degenerative Lumbar Spinal Stenosis. Spine 0;:E. [] Pannell WC, Savin DD, Scott TP, Wang JC, Daubs MD. Trends in the surgical treatment of lumbar spine disease in the United States. Spine J doi: 0.0/j.spinee [Epub ahead of print] [] Liu X, Wang Y, Qiu G, Weng X, Yu B. A systematic review with meta-analysis of posterior interbody fusion versus posterolateral fusion in lumbar spondylolisthesis. Eur Spine J 0;:. [] Lidar Z, Beaumont A, Lifshutz J, Maiman DJ. Clinical and radiological relationship between posterior lumbar interbody fusion and posterolateral lumbar fusion. Surg Neurol 00;:0. [] Wang Z, Fu S, Wu ZX, Zhang Y, Lei W. Ti Pedicle Screw System Augmentation for Posterior Lumbar Interbody Fusion. Spine 0;:00. [] Athanasakopoulos M, Mavrogenis AF, Triantafyllopoulos G, Koufos S, Pneumaticos SG. Posterior Spinal Fusion Using Pedicle Screws. Orthopedics 0;:e.
23 [] Jones-Quaidoo SM, Djurasovic M, Owens RK, Carreon LY. Superior articulating facet violation: percutaneous versus open techniques: Clinical article. J Neurosurg 0 Spine 0;:. [] Hu MW, Liu ZL, Zhou Y, et al. Posterior lumbar interbody fusion using spinous process and laminae. J Bone Joint Surg Br 0;:-. [0] Parker SL, Amin AG, Santiago-Dieppa D, et al. Incidence and Clinical Significance of Vascular Encroachment Resulting from Free Hand Placement of Pedicle Screws in the Thoracic and Lumbar Spine: Analysis of, Consecutive Screws. Spine 0 Jan. [Epub ahead of print] [] Oh HS, Kim JS, Lee SH, Liu WC, Hong SW. Comparison between the accuracy of percutaneous and open pedicle screw fixations in lumbosacral fusion. Spine J 0;:. [] Perez-Orribo L, Kalb S, Reyes PM, Chang SW, Crawford NR. Biomechanics of Lumbar Cortical Screw Rod Fixation Versus Pedicle Screw Rod Fixation With and Without Interbody Support. Spine 0;:. [] Santoni BG, Hynes RA, McGilvray KC, et al. Cortical bone trajectory for lumbar pedicle screws. Spine J 00;:. [] Matsukawa K, Yato Y, Kato T, et al. In Vivo Analysis of Insertional Torque During 0 Pedicle Screwing Using Cortical Bone Trajectory Technique. Spine 0;:E0. 0
24 [] Piaggio G, Elbourne DR, Pocock SJ, Evans SJ, Altman DG; CONSORT Group. Reporting of noninferiority and equivalence randomized trials: extension of the 0 CONSORT 00 statement. JAMA 0;0: 0. [] Wu Y, Tang H, Li Z, Zhang Q, Shi Z. Outcome of posterior lumbar interbody fusion versus posterolateral fusion in lumbar degenerative disease. J Clin Neurosci 0;:0. [] Lau D, Terman SW, Patel R, La Marca F, Park P. Incidence of and risk factors for superior facet violation in minimally invasive versus open pedicle screw placement during transforaminal lumbar interbody fusion: a comparative analysis: Clinical article. J Neurosurg Spine 0;:. [] Mobbs RJ. The medio-lateral-superior trajectory technique : an alternative cortical trajectory for pedicle fixation. Orthop Surg 0;:-.
25 Figure Legends 0 Figure. Cortical screw trajectory. On axial (A, L; B, S) and sagittal (C, L; D, S) CT images, the CS was inserted through the pedicle in a the supero-lateral direction from the entry point, which was located near the pars articularis. Figure. Flow diagram for enrolled patients. Figure. Mean VAS for back pain (A), mean VAS for radiating pain to the lower extremity (B), and mean ODI (C) scores by time point. The VAS and ODI were collected at each follow-up time. Error bars represent standard deviations. * Statistically significant difference between scores at baseline and at each follow-up time (P < 0.0) ** Statistically significant difference between groups at the follow-up times (P < 0.0)
26 Table. Demographic Data Group B Group C P Case - Age (year). ±.. ±. 0. Gender (male / female) / / 0. Height (cm). ± 0.. ±. 0. Weight (kg). ±.. ±. 0. BMI (kg/m ). ±.. ±. 0.0 BMD (T-score). ± 0.. ± Smoking status 0. smoker (%) (.) (.%) non-smoker (%) (.) (.%) Lumbar pathology (%) LSS with foraminal stenosis 0 (.) (.) Isthmic spondylolisthesis (.) (.) Degenerative spondylolisthesis (0.) (.) Fusion level 0. L- (%) (.) (.) L-S (%) 0 (.) 0 (.) Values in data cells represent mean ± SD (standard deviation). BMI, body mass index; BMD, bone mineral density; LSS, lumbar spinal stenosis
27 Table. Fusion rate at one year post-surgery Group B (n = ) Using dynamic radiographs at postoperative one year Group C (n = ) P Fusion Nonunion Union rate (%).. 0. Using CT scans at postoperative one year Fusion Nonunion Union rate (%).. 0.
28 Table. Clinical outcomes Clinical Parameters Group B (n = ) Group C (n = ) P VAS for lower back pain Pre-operative. ±.. ±. 0. week postoperative. ±.. ±. 0.0* weeks postoperative. ±.0.0 ± weeks postoperative.0 ± 0.. ±. 0. month postoperative. ± 0.. ± months postoperative. ± 0.. ±.0 0. months postoperative.0 ±.. ± year postoperative.0 ±.0. ±. 0. VAS for radiating pain Pre-operative. ±.. ±. 0. month postoperative. ± 0..0 ± months postoperative.0 ± ± months postoperative. ± 0.. ± year postoperative. ± 0.. ± ODI score Pre-operative. ± 0.. ±. 0. months postoperative. ±.. ±. 0.0 months postoperative 0. ±.. ± 0. 0.
29 year postoperative.0 ±. 0. ±. 0. Values in data cells represent mean ± SD (standard deviation). VAS, visual analogue scale; ODI, oswestry disability index *, meaning significant difference between groups (P < 0.0)
30 Table. Surgical outcomes Group B (n = ) Group C (n = ) P Blood loss (ml) 0 ± 0 ± 0 0.0* Operation time (hours). ± 0.. ± * Hospital stay (day). ±.. ±. 0. Incision length (mm) 0. ±.. ±. 0.0* Values in data cells represent mean ± SD (standard deviation). *, meaning significant difference between groups (P < 0.0)
31 AC C EP TE D M AN U SC RI PT
32
33
34
35
36 本文献由 学霸图书馆 - 文献云下载 收集自网络, 仅供学习交流使用 学霸图书馆 ( 是一个 整合众多图书馆数据库资源, 提供一站式文献检索和下载服务 的 小时在线不限 IP 图书馆 图书馆致力于便利 促进学习与科研, 提供最强文献下载服务 图书馆导航 : 图书馆首页文献云下载图书馆入口外文数据库大全疑难文献辅助工具
Supporting Information. Electrochemiluminescence for Electric-Driven Antibacterial. Therapeutics
Supporting Information Electrochemiluminescence for Electric-Driven Antibacterial Therapeutics Shanshan Liu, a,b Huanxiang Yuan, a Haotian Bai, a Pengbo Zhang, a Fengting Lv, a Libing Liu, a Zhihui Dai,
More informationRacial disparities in the management of acne: evidence from the National Ambulatory Medical Care Survey,
Journal of Dermatological Treatment ISSN: 0954-6634 (Print) 1471-1753 (Online) Journal homepage: http://www.tandfonline.com/loi/ijdt20 Racial disparities in the management of acne: evidence from the National
More informationOptimization of Processing Parameters of Stabilizers After Enzymes Hydrolysis for Cloudy Ginkgo Juice
Optimization of Processing Parameters of Stabilizers After Enzymes Hydrolysis for Cloudy Ginkgo Juice Haifeng Yu, Junyan Liu and Jingxi Yang 1 Introduction Ginkgo biloba, dating back 300 million years,
More informationChapter 5 Trimalleolar Ankle Fracture: Posterior Plate for Posterior Malleolus Fractures
Chapter 5 Trimalleolar Ankle Fracture: Posterior Plate for Posterior Malleolus Fractures Roy I. Davidovitch and Alexander M. Crespo Introduction Trimalleolar ankle fractures with a posterior malleolus
More informationAccepted Manuscript. Robotics in Orthopedics: A Brave New World. Brian S. Parsley, MD, Associate Professor
Accepted Manuscript Robotics in Orthopedics: A Brave New World Brian S. Parsley, MD, Associate Professor PII: S0883-5403(18)30163-3 DOI: 10.1016/j.arth.2018.02.032 Reference: YARTH 56428 To appear in:
More informationAccepted Manuscript. Hemorrhagic cystitis associated with gefitinib treatment: a case report. Peng Zhang, Jinjing Tu, Tieding Chen, Rubing Li
Accepted Manuscript Hemorrhagic cystitis associated with gefitinib treatment: a case report Peng Zhang, Jinjing Tu, Tieding Chen, Rubing Li PII: S0090-4295(18)30555-7 DOI: 10.1016/j.urology.2018.05.035
More informationACCEPTED ARTICLE PREVIEW. Accepted manuscript
First in Class Angiotensin Receptor Neprilysin Inhibitor in Heart Failure Orly Vardeny, PharmD, MS, Travis Tacheny, Scott D. Solomon, MD Cite this article as: Orly Vardeny, PharmD, MS, Travis Tacheny,
More informationFetal Response to Intramuscular Epinephrine for Anaphylaxis during Maternal Penicillin Desensitization for Secondary Syphilis
The Journal of Maternal-Fetal & Neonatal Medicine ISSN: 1476-7058 (Print) 1476-4954 (Online) Journal homepage: http://www.tandfonline.com/loi/ijmf20 Fetal Response to Intramuscular Epinephrine for Anaphylaxis
More informationThinking & Reasoning Publication details, including instructions for authors and subscription information:
This article was downloaded by: [Umeå University Library] On: 07 October 2013, At: 11:46 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer
More informationAccepted Manuscript. Red yeast rice preparations: are they suitable substitutions for statins?
Accepted Manuscript Red yeast rice preparations: are they suitable substitutions for statins? Carlos A. Dujovne, MD, Fellow NLA, Certified Clinical Lipidologist PII: S0002-9343(17)30591-0 DOI: 10.1016/j.amjmed.2017.05.013
More informationHong-qi Zhang Min-zhong Lin Jin-song Li Ming-xing Tang Chao-feng Guo Jian-huang Wu Jin-yang Liu
Arch Orthop Trauma Surg (2013) 133:333 341 DOI 10.1007/s00402-012-1669-2 ORTHOPAEDIC SURGERY One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of
More informationEffects of idebenone on electroencephalograms of patients with cerebrovascular disorders
Arch. Gerontol. Geriatr., 8 (1989) 355-366 355 Elsevier AGG 00266 Effects of idebenone on electroencephalograms of patients with cerebrovascular disorders Takashi Nakano a Matu6 Miyasaka a, Katsumi Mori
More informationMastering the Initial Dissection and Cannulation: Making Ablation Easy and Safe
Chapter 5 Mastering the Initial Dissection and Cannulation: Making Ablation Easy and Safe 1 INTRODUCTION A good initial dissection with wide mobilization of the left atrium (LA) by dividing its attachments
More informationuncorrected proof version
Galley Proof 8/02/2017; 9:17 File: jcm 1-jcm708.tex; BOKCTP/ljl p. 1 Journal of Computational Methods in Sciences and Engineering -1 (2017) 1 10 1 DOI 10.3233/JCM-170708 IOS Press 1 2 3 Comparison of sliding
More informationSynthetic Tannins Structure by MALDI-TOF Mass Spectroscopy
Synthetic Tannins Structure by MALDI-TOF Mass Spectroscopy S. Giovando, 1 A. Pizzi, 2 H. Pasch, 3,4 K. Rode 4 1 Centro Ricerche per la Chimica Fine Srl, S.Michele Mondovi, Italy 2 ENSTIB-LERMAB, Nancy
More informationIndacaterol, a once-daily beta 2 -agonist, versus twice-daily beta-agonists or placebo for chronic obstructive pulmonary disease (Protocol)
Indacaterol, a once-daily beta 2 -agonist, versus twice-daily beta-agonists or placebo for chronic obstructive pulmonary disease (Protocol) Geake JB, Dabscheck EJ, Wood-Baker R This is a reprint of a Cochrane
More informationJournal of Chromatography A 819 (1998)
Journal of Chromatography A 89 (998) 33 42 Investigation of potential degradation products of a newly synthesised b-lactam antibiotic by multi-stage liquid chromatography electrospray mass spectrometry
More informationSOME PRACTICAL IMPROVEMENTS IN THE CONTINUAL REASSESSMENT METHOD FOR PHASE I STUDIES
STATISTICS IN MEDICINE, VOL. 14, 1149-1161 (1995) SOME PRACTICAL IMPROVEMENTS IN THE CONTINUAL REASSESSMENT METHOD FOR PHASE I STUDIES STEVEN N. GOODMAN, MARIANNA L. ZAHURAK AND STEVEN PIANTADOSI Johns
More informationHow might treatment of ALK-positive non-small cell lung cancer change in the near future?
Expert Review of Anticancer Therapy ISSN: 1473-7140 (Print) 1744-8328 (Online) Journal homepage: http://www.tandfonline.com/loi/iery20 How might treatment of ALK-positive non-small cell lung cancer change
More informationAccepted Manuscript. Dural arteriovenous fistula between the inferolateral trunk and cavernous sinus draining to the ophthalmic vein: a case report
Accepted Manuscript Dural arteriovenous fistula between the inferolateral trunk and cavernous sinus draining to the ophthalmic vein: a case report Kan Xu, Kun Hou, Baofeng Xu, Yunbao Guo, Jinlu Yu PII:
More informationComparison of Carotid Artery Stenting and Carotid Endarterectomy in Patients with Symptomatic Carotid Artery Stenosis: A Single Center Study
Adv Ther (2013) 30:845 853 DOI 10.1007/s25-013-0058-8 ORIGINAL RESEARCH Comparison of Carotid Artery Stenting and Carotid Endarterectomy in Patients with Symptomatic Carotid Artery Stenosis: A Single Center
More informationCharacterization of a prototype MR-compatible Delta4 QA-system in a 1.5 tesla MR-linac
Physics in Medicine and Biology ACCEPTED MANUSCRIPT Characterization of a prototype MR-compatible Delta QA-system in a. tesla MR-linac To cite this article before publication: J H Wilfred de Vries et al
More informationLisfranc Arthrodesis for Chronic Pain: A Cannulated Screw Technique
Lisfranc Arthrodesis for Chronic Pain: A Cannulated Screw Technique Nine patients with injury to the tarsometatarsal joint underwent fusion with cannulated screw fixation after conservative treatment had
More informationEffects of regular exercise on asthma control in young adults
Journal of Asthma ISSN: 0277-0903 (Print) 1532-4303 (Online) Journal homepage: http://www.tandfonline.com/loi/ijas20 Effects of regular exercise on asthma control in young adults Dr Sirpa A.M. Heikkinen,
More informationPharmacokinetics of a Novel Orodispersible Tablet of Sildenafil in Healthy Subjects
Clinical Therapeutics/Volume 36, Number 2, 2014 Pharmacokinetics of a Novel Orodispersible Tablet of Sildenafil in Healthy Subjects Bharat Damle, PhD 1 ; Gregory Duczynski, MS 2 ; Barrett W. Jeffers, PhD
More informationHow Advertising Slogans
How Advertising Slogans Can Prime Evaluations of Brand Extensions David M. Boush University of Oregon ABSTRACT Different versions of a brand slogan were presented to each of three treatment groups before
More informationORIGINAL ARTICLE ABSTRACT SUMMARY AT A GLANCE INTRODUCTION
bs_bs_banner ORIGINAL ARTICLE Budesonide/formoterol maintenance and reliever therapy via Turbuhaler versus fixed-dose budesonide/formoterol plus terbutaline in patients with asthma: Phase III study results
More informationThe role of air plethysmography in the diagnosis of chronic venous insufficiency
The role of air plethysmography in the diagnosis of chronic venous insufficiency Enrique Criado, MD, Mark A. Farber, MD, William A. Marston, MD, Patty F. Daniel, RN, RVT, Cynthia B. Burnham, RN, RVT, and
More informationNON-NARCOTIC ORALLY EFFECTIVE, CENTRALLY ACTING ANALGESIC FROM AN AYURVEDIC DRUG
Journal of Ethnopharmocology, ll(l984) 309-317 Elsevier Scientific Publishers Ireland Ltd. 309 NON-NARCOTIC ORALLY EFFECTIVE, CENTRALLY ACTING ANALGESIC FROM AN AYURVEDIC DRUG CX ATAL, M.A. SIDDIQUI, USHA
More informationAuthor s Accepted Manuscript
Author s Accepted Manuscript Rheumatologic symptoms in oncologic patients on PD-1 inhibitors Wilson F. Kuswanto, Lindsey A. MacFarlane, Lydia Gedmintas, Alexandra Mulloy, Toni K. Choueiri, Bonnie Bermas
More informationThe conundrum of hodgkin lymphoma nodes: To be or not to be included in the involved node radiation fields. The EORTC-GELA lymphoma group guidelines
Radiotherapy and Oncology 88 (2008) 202 210 www.thegreenjournal.com Hodgkin guidelines The conundrum of hodgkin lymphoma nodes: To be or not to be included in the involved node radiation fields. The EORTC-GELA
More informationLow- vs. high-pressure suction drainage after total knee arthroplasty: a double-blind randomized controlled trial
JAN JOURNAL OF ADVANCED NURSING ORIGINAL RESEARCH Low- vs. high-pressure suction drainage after total knee arthroplasty: a double-blind randomized controlled trial Rafael Calvo, M a José Martínez-Zapata,
More informationDivergent Thinking and Evaluation Skills: Do They Always Go Together?
Journal of Creative Behavior MAGDALENA GROHMAN ZOFIA WODNIECKA MARCIN KLUSAK Divergent Thinking and Evaluation Skills: Do They Always Go Together? ABSTRACT INTRODUCTION The aim of the present study was
More informationFunctional Outcome of Unstable Distal Radius Fractures: ORIF With a Volar Fixed-Angle Tine Plate Versus External Fixation
Functional Outcome of Unstable Distal Radius Fractures: ORIF With a Volar Fixed-Angle Tine Plate Versus External Fixation Thomas W. Wright, MD, MaryBeth Horodyski, EdD, Gainesville, FL, Dean W. Smith,
More informationArtificial total disc replacement versus fusion for lumbar degenerative disc disease: a meta analysis of randomized controlled trials
Arch Orthop Trauma Surg (2014) 134:149 158 DOI 10.1007/s00402-013-1905-4 ORTHOPAEDIC SURGERY Artificial total disc replacement versus fusion for lumbar degenerative disc disease: a meta analysis of randomized
More informationEffects of Angle of Approach on Cursor Movement with a Mouse: Consideration of Fitts' Law
Pergamon Computers in Human Behavior, Vol. 12, No. 3, pp. 481-495, 1996 Copyright 1996 Elsevier Science Ltd Printed in Great Britain. All rights reserved 0747-5632/96 $15.00 + 0.00 S0747-5632(96) 00020-9
More informationHard-tissue alterations following immediate implant placement in extraction sites
J Clin Periodontol 2004; 31: 820 828 doi: 10.1111/j.1600-051X.2004.00565.x Copyright r Blackwell Munksgaard 2004 Printed in Denmark. All rights reserved Hard-tissue alterations following immediate implant
More informationParallel Stent Graft Techniques to Facilitate Endovascular Repair in the Aortic Arch
Parallel Stent Graft Techniques to Facilitate Endovascular Repair in the Aortic Arch 35 Frank J. Criado Introduction Whether using a traditional open-chest approach or endovascular techniques, the arch
More informationCortical Screws as an Alternative for Pedicle Screw Fixation for Unstable Degenerative Lumbar Spondylolisthesis: Technical note and Initial Results
Baptist Health South Florida Scholarly Commons @ Baptist Health South Florida All Publications 10-2017 Cortical Screws as an Alternative for Pedicle Screw Fixation for Unstable Degenerative Lumbar Spondylolisthesis:
More informationHYDRONEPHROSIS DUE TO THE INFERIOR POLAR ARTERY :
HYDRONEPHROSIS DUE TO THE INFERIOR POLAR ARTERY : LATE RESULTS AFTER NEPHROPLICATION. Appendix of Recent Cases By A. WILFRID ADAMS, F.R.C.S. Bristol Royal Infirmary FOR hydronephrosis due to an aberrant,
More informationRAVEN'S COLORED PROGRESSIVE MATRICES AND INTELLECTUAL IMPAIRMENT IN PATIENTS WITH FOCAL BRAIN DAMAGE
RAVEN'S COLORED PROGRESSIVE MATRICES AND INTELLECTUAL IMPAIRMENT IN PATIENTS WITH FOCAL BRAIN DAMAGE Claudio Villardita (Neuropsychology Unit, Department of Neurology, University of Catania) INTRODUCTION
More informationTHE RATIONALITY/EMOTIONAL DEFENSIVENESS SCALE- I. INTERNAL STRUCTURE AND STABILITY
Joouml of Psychosomaric Research, Vol. 35. No. 4/S, pp. 545-554, 1991. 0534-3999191 $3.00+.00 Printed in Great Britain 0 1991 Pergamon Press plc THE RATIONALITY/EMOTIONAL DEFENSIVENESS SCALE- I. INTERNAL
More informationPulmonary Vein Stenosis After Catheter Ablation of Atrial Fibrillation
Pulmonary Vein Stenosis After Catheter Ablation of Atrial Fibrillation E.B. SAAD Introduction Catheter ablation around the pulmonary veins (PVs) has become the treatment of choice for symptomatic patients
More informationInt J Clin Exp Med 2018;11(2): /ISSN: /IJCEM Yi Yang, Hao Liu, Yueming Song, Tao Li
Int J Clin Exp Med 2018;11(2):1278-1284 www.ijcem.com /ISSN:1940-5901/IJCEM0063093 Case Report Dislocation and screws pull-out after application of an Isobar TTL dynamic stabilisation system at L2/3 in
More informationCost-Effectiveness of Adding Rh-Endostatin to First-Line Chemotherapy in Patients With Advanced Non-Small-Cell Lung Cancer in China
Clinical Therapeutics/Volume 33, Number 10, 2011 Cost-Effectiveness of Adding Rh-Endostatin to First-Line Chemotherapy in Patients With Advanced Non-Small-Cell Lung Cancer in China Bin Wu, PhD 1, Huafeng
More informationEnergy Metabolism in Oreochromis niloticus
Aquuculture, 79 (1989) 283-291 Eisevier Science Pubhshers B.V., Amsterdam - Printed in The Netherlands 283 Energy Metabolism in Oreochromis niloticus K.-H. MEYER-BURGDORFF, M.F. OSMAN and K.D. GUNTHER
More informationClinical investigation of chronic subdural hematoma with impending brain herniation on arrival
DOI 10.1007/s10143-017-0861-9 ORIGINAL ARTICLE Clinical investigation of chronic subdural hematoma with impending brain herniation on arrival Hiroaki Matsumoto 1 & Hiroaki Hanayama 1 & Takashi Okada 1
More informationA. Alonso-Burgos a, *, E. García-Tutor b, G. Bastarrika a, D. Cano a, A. Martínez-Cuesta a, L.J. Pina a
Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 585 593 Preoperative planning of deep inferior epigastric artery perforator flap reconstruction with multislice-ct angiography: imaging
More information164 J.A.H. an Laarho en et al. / International Journal of Pharmaceutics 232 (2002) An example of a sustained release system is a contraceptive
International Journal of Pharmaceutics 232 (2002) 163 173 www.elsevier.com/locate/ijpharm In vitro release properties of etonogestrel and ethinyl estradiol from a contraceptive vaginal ring J.A.H. van
More informationTitle: Clinical and histopathological features of immunoglobulin G4-associated autoimmune hepatitis in children
Title: Clinical and histopathological features of immunoglobulin G4-associated autoimmune hepatitis in children Short title: Immunoglobulin G4-associated autoimmune hepatitis in children Yusuf Aydemir¹,
More informationContrasting timing of virological relapse after discontinuation of. tenofovir or entecavir in hepatitis B e antigen-negative patients.
Contrasting timing of virological relapse after discontinuation of tenofovir or entecavir in hepatitis B e antigen-negative patients. Running title: Difference after stopping TDF or ETV Christoph Höner
More informationValidation of ATS clinical practice guideline cut-points for FeNO in asthma
Accepted Manuscript Validation of ATS clinical practice guideline cut-points for FeNO in asthma Maria Jeppegaard, Sandra Veidal, Asger Sverrild, Vibeke Backer, Celeste Porsbjerg PII: S0954-6111(18)30296-8
More informationComputerized Quantitative Coronary Angiography Applied to Percutaneous Transluminal Coronary Angioplasty: Advantages and Limitations
Computerized Quantitative Coronary Angiography Applied to Percutaneous Transluminal Coronary Angioplasty: Advantages and Limitations P.W. Serruys, F. Booman, G.J. Troost, J.H.C. Reiber, J.J. Gerbrands*,
More informationOvarian cancer is the most lethal gynecologic malignancy
Original Research Laparoscopy Compared With Laparotomy for Debulking Ovarian Cancer After Neoadjuvant Chemotherapy Alexander Melamed, MD, MPH, Roni Nitecki, MD, David M. Boruta II, MD, Marcela G. del Carmen,
More informationSmall pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening
Review Article Small pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening Joan E. Walter, Marjolein A. Heuvelmans, Matthijs Oudkerk University Medical Center
More informationThe Use of Transdermal Buprenorphine to Relieve Radiotherapy-Related Pain in Head and Neck Cancer Patients
Cancer Investigation, 31:412 420, 2013 ISSN: 0735-7907 print / 1532-4192 online Copyright C 2013 Informa Healthcare USA, Inc. DOI: 10.3109/07357907.2013.800094 IMAGING, DIAGNOSIS, PROGNOSIS The Use of
More informationColchicine for prevention and treatment of cardiac diseases: A meta-analysis
DOI: 10.1111/1755-5922.12226 ORIGINAL RESEARCH ARTICLE Colchicine for prevention and treatment of cardiac diseases: A meta-analysis Nikolaos Papageorgiou 1,2, Alexandros Briasoulis 3, George Lazaros 2
More informationIncidence and predictors of synchronous liver metastases in patients with gastrointestinal stromal tumors (GISTs)
Accepted Manuscript Incidence and predictors of synchronous liver metastases in patients with gastrointestinal stromal tumors (GISTs) Apostolos Gaitanidis, Michail Alevizakos, Alexandra Tsaroucha, Constantinos
More informationIntroduction. urinary erythropoietin, and the two are indistinguishable
BIOPHARMACEUTICS & DRUG DISPOSITION Biopharm. Drug Dispos. 21: 211 219 (2000) DOI: 10.1002/bdd.231 Comparative Pharmacokinetics, Safety, and Tolerability After Subcutaneous Administration of Recombinant
More informationABSTRACT. questions in the version of NorAQ administered to men (m-noraq) against the interview model.
GENDER MEDICINE/VOL. 8,NO. 2, 2011 NorVold Abuse Questionnaire for Men (m-noraq): Validation of New Measures of Emotional, Physical, and Sexual Abuse and Abuse in Health Care in Male Patients Katarina
More informationEfficacy, safety and impact on β
J Endocrinol Invest (2016) 39:1061 1074 DOI 10.1007/s40618-016-0465-1 ORIGINAL ARTICLE Efficacy, safety and impact on β cell function of dipeptidyl peptidase 4 inhibitors plus metformin combination therapy
More informationPrevalence of different HIV-1 subtypes in sexual transmission in China: a systematic review and meta-analysis
Epidemiol. Infect. (2016), 144, 2144 2153. Cambridge University Press 2016 doi:10.1017/s0950268816000212 Prevalence of different HIV-1 subtypes in sexual transmission in China: a systematic review and
More informationA Diabetes Mobile App With In-App Coaching From a Certified Diabetes Educator Reduces A1C for Individuals With Type 2 Diabetes
765650TDEXXX10.1177/0145721718765650Impact of a Diabetes App and Coaching Program on A1CKumar et al research-article2018 Impact of a Diabetes App and Coaching Program on A1C 1 A Diabetes Mobile App With
More informationNebulized Magnesium for Moderate and Severe Pediatric Asthma: A Randomized Trial
50:1191 1199 (2015) Nebulized Magnesium for Moderate and Severe Pediatric Asthma: A Randomized Trial Khalid Alansari, MD, FRCPC, FAAP(PEM), 1,2,3 * Wessam Ahmed, 2 Bruce L. Davidson, MD, MPH, 4 Mohamed
More informationSYSTEMATIC REVIEW PROTOCOL
Effectiveness of Silexan oral lavender essential oil compared to inhaled lavender essential oil aromatherapy on sleep in adults: a systematic review protocol Martha J. Greenberg 1,2 Jason T. Slyer 1,2
More informationCongenital absence of teeth is a common dental
CASE REPORT Management of congenitally missing second premolars with orthodontics and single-tooth implants Roy Sabri, DDS, MS Beirut, Lebanon This article describes the treatment of an adolescent girl
More informationEffect of health Baduanjin Qigong for mild to moderate Parkinson s disease
bs_bs_banner Geriatr Gerontol Int 2016; 16: 911 919 ORIGINAL ARTICLE: EPIDEMIOLOGY, CLINICAL PRACTICE AND HEALTH Effect of health Baduanjin Qigong for mild to moderate Parkinson s disease Chun-Mei Xiao
More informationMarlowe Crowne Social Desirability Scale and Short Form C: Forensic Norms
Marlowe Crowne Social Desirability Scale and Short Form C: Forensic Norms Paul Andrews Private Practice, Tyler, Texas Robert G. Meyer University of Louisville Marlowe Crowne Social Desirability Scale (MC)
More informationInterspinous Fusion Devices. Midterm results. ROME SPINE 2012, 7th International Meeting Rome, 6-7 December 2012
Interspinous Fusion Devices. Midterm results. ROME SPINE 2012, 7th International Meeting Rome, 6-7 December 2012 Posterior distraction and decompression Secure Fixation and Stabilization Integrated Bone
More informationJournal of Chromatography B, 857 (2007)
Journal of Chromatography B, 857 (2007) 287 295 Determination of serum uric acid using high-performance liquid chromatography (HPLC)/isotope dilution mass spectrometry (ID-MS) as a candidate reference
More informationA Motivational Intervention to Reduce Cigarette
A Motivational Intervention to Reduce Cigarette Smoking Among College Students: Overview and Exploratory Investigation Keith C. Herman and Beth Fahnlander College counselors can play an important role
More informationGlucose-lowering activity of the dipeptidyl peptidase-4 inhibitor saxagliptin in drug-naive patients with type 2 diabetes*
ORIGINAL ARTICLE doi: 10.1111/j.1463-1326.2008.00876.x Glucose-lowering activity of the dipeptidyl peptidase-4 inhibitor saxagliptin in drug-naive patients with type 2 diabetes* J. Rosenstock, 1 S. Sankoh
More informationLONG-TERM RESULTS OF A PHASE III TRIAL COMPARING ONCE-DAILY RADIOTHERAPY WITH TWICE-DAILY RADIOTHERAPY IN LIMITED- STAGE SMALL-CELL LUNG CANCER
doi:10.1016/j.ijrobp.2004.01.055 Int. J. Radiation Oncology Biol. Phys., Vol. 59, No. 4, pp. 943 951, 2004 Copyright 2004 Elsevier Inc. Printed in the USA. All rights reserved 0360-3016/04/$ see front
More informationNatural Course of Peripartum Cardiomyopathy
Natural Course of Peripartum Cardiomyopathy By JOHN G. DEMAKIS, M.D., SHAHBUDIN H. RAHIMTOOLA, M.B., M.R.C.P.E., GEORGE C. SUTrON, M.D., W. ROBERT MEADOWS, M.D., PAUL B. SZANTO, M.D., JoHN R. TOBIN, M.D.,
More informationSplenomegaly and Hemolytic Anemia Induced in Rats by Methylcellulose - An electron microscopic study '
Splenomegaly and Hemolytic Anemia Induced in Rats by Methylcellulose - An electron microscopic study ' EMMA WENNBERG AND LEON WEISS Department of Anatomy, The johns Hopkins University School of Medicine,
More informationAntiproliferative, antimigratory, and anticlonogenic effects of Hedyotis diffusa, Panax ginseng, and their combination on colorectal cancer cell lines
Journal of Herbs, Spices & Medicinal Plants ISSN: 1049-6475 (Print) 1540-3580 (Online) Journal homepage: http://www.tandfonline.com/loi/whsm20 Antiproliferative, antimigratory, and anticlonogenic effects
More informationA LABORATORY TASK FOR INDUCTION OF MOOD STATES*
khav. Res. & Therapy. 1968. Vol. 6. pp. 473 to 462. Pergamon Press. Printed in Englmd A LABORATORY TASK FOR INDUCTION OF MOOD STATES* EMMETT VELTEN, JR.? University of Southern California (Received 15
More informationTreatment of Class III Malocclusions Using Miniplate and Mini-Implant Anchorage
Treatment of Class III Malocclusions Using Miniplate and Mini-Implant Anchorage Seung-Hak Baek, Il-Hyung Yang, Keun-Woo Kim, and Hyo-Won Ahn Orthodontic miniplates and mini-implants have become essential
More informationMemory-based attentional capture by colour and shape contents in visual working memory
Visual Cognition ISSN: 1350-6285 (Print) 1464-0716 (Online) Journal homepage: http://www.tandfonline.com/loi/pvis20 Memory-based attentional capture by colour and shape contents in visual working memory
More informationPulley lesions in rotator cuff tears: prevalence, etiology, and concomitant pathologies
Arch Orthop Trauma Surg (2017) 137:1097 1105 DOI 10.1007/s00402-017-2721-z ARTHROSCOPY AND SPORTS MEDICINE Pulley lesions in rotator cuff tears: prevalence, etiology, and concomitant pathologies Nael Hawi
More informationGomputed tomography of the normal temporomaandibular joint
Gomputed tomography of the normal temporomaandibular joint EDWIN h. GHRISTiANSENi, TERENCE T: CHAN^, JOSEPH R. THOMPSON^ ANTON N. HASSO', DAVID B. HINSHAW JR' AND SIGVARD KOPP* ^Department of Endodontics^
More informationEGC Diagnosis of Paroxysmal Supraventricular Tachycardias in Patients without Preexcitation
REVIEW ARTICLE EGC Diagnosis of Paroxysmal Supraventricular Tachycardias in Patients without Preexcitation Esteban González-Torrecilla, M.D., Ph.D., Angel Arenal, M.D., Felipe Atienza, M.D., Ph.D., Tomás
More informationElectrical Acupoint Stimulation Changes Body Composition and the Meridian Systems in Postmenopausal Women with Obesity
The American Journal of Chinese Medicine, Vol. 38, No. 4, 683 694 2010 World Scientific Publishing Company Institute for Advanced Research in Asian Science and Medicine DOI: 10.1142/S0192415X10008159 Electrical
More informationuncorrected proof version
Galley Proof 4/01/2018; 9:37 File: thc 1-thc170956.tex; BOKCTP/xjm p. 1 Technology and Health Care -1 (2017) 1 9 1 DOI 10.3233/THC-170956 IOS Press 1 2 3 Ozone injection with or without percutaneous microdiscectomy
More informationProtective effect of HTK solution on postoperative pulmonary function in infants with CHD and PAH
Bioscience Reports: this is an Accepted Manuscript, not the final Version of Record. You are encouraged to use the Version of Record that, when published, will replace this version. The most up-to-date
More informationAddress: Department of General Surgery, Royal Bolton Hospital, Bolton, UK. ; tel:
Article type : Systematic Review Accepted Article 875-2017.R1 Systematic Review Effect of mesalazine on recurrence of diverticulitis in patients with symptomatic uncomplicated diverticular disease: a meta-analysis
More informationEffects of Mattress Material on Body Pressure Profiles in Different Sleeping Postures
Effects of Mattress Material on Body Pressure Profiles in Different Sleeping Postures Fan-Zhe Low, BEng, Matthew Chin-Heng Chua, PhD, Pan-Yin Lim, BEng, and Chen-Hua Yeow, PhD ABSTRACT Objectives: This
More informationHepatitis B virus (HBV) infection is a global health
GASTROENTEROLOGY 2012;142:1140 1149 High Levels of Hepatitis B Surface Antigen Increase Risk of Hepatocellular Carcinoma in Patients With Low HBV Load TAI CHUNG TSENG,*,, ** CHUN JEN LIU,, HUNG CHIH YANG,,#
More informationCombining ECMO with IABP for the Treatment of Critically Ill Adult Heart Failure Patients
Heart, Lung and Circulation (2014) 23, 363 368 1443-9506/04/$36.00 http://dx.doi.org/10.1016/j.hlc.2013.10.081 ORIGINAL ARTICLE Combining ECMO with IABP for the Treatment of Critically Ill Adult Heart
More informationSerum mir-182 and mir-331-3p as diagnostic and prognostic markers in patients with hepatocellular carcinoma
Tumor Biol. (2015) 36:7439 7447 DOI 10.1007/s13277-015-3430-2 RESEARCH ARTICLE Serum mir-182 and mir-331-3p as diagnostic and prognostic markers in patients with hepatocellular carcinoma Lin Chen 1 & Feihu
More informationDevelopment and psychometric evaluation of the Thirst Distress Scale for patients with heart failure
728624CNU0010.1177/1474515117728624European Journal of Cardiovascular Nursing 0(0)Waldréus et al. research-article2017 Original Article Development and psychometric evaluation of the Thirst Distress Scale
More informationEfficacy and Safety of Saxagliptin Compared with Acarbose in Chinese. Patients with Type 2 Diabetes Mellitus Uncontrolled on Metformin
Efficacy and Safety of Saxagliptin Compared with Acarbose in Chinese Patients with Type 2 Diabetes Mellitus Uncontrolled on Metformin Monotherapy: Results of a Phase IV Open-Label Randomized Controlled
More informationTumor Spread Through Air Spaces Identifies a Distinct Subgroup With Poor Prognosis in Surgically Resected Lung Pleomorphic Carcinoma
1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 19 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 41 42 43 44 45 46 47 48 49 5 51 52 53 54 55 Q15 Q1 Q6 Q2 [ Original Research ] Tumor Spread Through
More informationFunctional and Structural Outcome After Arthroscopic Full-Thickness Rotator Cuff Repair: Single-Row Versus Dual-Row Fixation
Functional and Structural Outcome After Arthroscopic Full-Thickness Rotator Cuff Repair: Single-Row Versus Dual-Row Fixation Hiroyuki Sugaya, M.D., Kazuhiko Maeda, M.D., Keisuke Matsuki, M.D., and Joji
More informationAbsolute monocyte count predicts overall survival in mantle cell lymphomas: correlation with tumourassociated
Hematological Oncology Hematol Oncol 2014; 32: 178 186 Published online 29 October 2013 in Wiley Online Library (wileyonlinelibrary.com).2106 Original Research Article Absolute monocyte count predicts
More informationLung cancer is one of the major tumors that causes human
ORIGINAL RESEARCH Analysis of Contrast-Enhanced Ultrasound Perfusion Patterns and Time-Intensity Curves for Metastatic Lymph Nodes From Lung Cancer Preliminary Results Shanshan Yin, MD, Qiuli Cui, MSc,
More informationUse of Digoxin for Heart Failure and Atrial Fibrillation in Elderly Patients
J.W.M. Cheng and I. Rybak The American Journal of Geriatric Pharmacotherapy Use of Digoxin for Heart Failure and Atrial Fibrillation in Elderly Patients Judy W.M. Cheng, BS, PharmD, MPH 1,2 ; and Iwona
More informationYang S-S, Gao Y, Wang D-Y, Xia B-R, Liu Y-D, Qin Y, Ning X-M, Li G-Y, Hao L-X, Xiao M & Zhang Y-Y (2016) Histopathology. DOI: /his.
Histopathology 2016 DOI: 10.1111/his.12933 Overexpression of eukaryotic initiation factor 5A2 (EIF5A2) is associated with cancer progression and poor prognosis in patients with early-stage cervical cancer
More informationReliability and Factorial Structure of the Chinese Version of the State-Trait Anxiety Inventory
Journal of Psychopathology and Behavioral Assessment, Vol. 10, No. 4, 1988 Reliability and Factorial Structure of the Chinese Version of the State-Trait Anxiety Inventory Daniel T. L. Shek ~ Accepted:
More informationEpithelial Barrier Defects in HT-29/B6 Colonic Cell Monolayers Induced by Tumor Necrosis Factor α
Epithelial Barrier Defects in HT-29/B6 Colonic Cell Monolayers Induced by Tumor Necrosis Factor α ALFRED H. GITTER, a,b KERSTIN BENDFELDT, a HEINZ SCHMITZ, c JÖRG-DIETER SCHULZKE, c CARL J. BENTZEL, d
More information