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Background: Exploration of the benefits and timing of surgical decompression in spinal cord injury (SCI) has been a research hotspot. However, despite the higher volume and increasing emphasis on quality there remains no bibliometric view on SCI and surgical decompression. In this study, we aimed to perform bibliometric analysis to reveal the core countries, affiliations, journals, authors, and developmental trends in SCI and surgical decompression across the past 50years. Methods: Articles and reviews were retrieved from web of science core collection between 1975 and 2024. The bibliometrix package in R was used for data analysis and visualizing. Results: A total of 8,688 documents were investigated, indicating an ascending trend in annual publications. The USA and China played as the leaders in scientific productivity. The University of Toronto led in institutional productions. Core authors, such as Michael G. Fehlings, showed high productivity, and occasional authors showed widespread interests. Core journals like Spine and Spinal Cord served as beacons in this field. The interaction of core authors and international collaboration accentuated the cross-disciplinary feature of the field. Prominent documents emphasized the clinical significance of early decompression in 24h post SCI. Conclusion: Based on comprehensive bibliometric analysis and literature review, we identified the hotspots and future directions of this field: (1) further investigation into the molecular and cellular mechanisms to provide preclinical evidence for biological effects of early surgical decompression in SCI animal models; (2) further evaluation and validation of the optimal time window of surgical decompression based on large cohort, considering the inherent heterogeneity of subpopulations in complicated immune responses post SCI; (3) further exploration on the benefits of early decompression on the neurological, functional, and clinical outcomes in acute SCI; (4) evaluation of the optimal surgical methods and related outcomes; (5) applications of artificial intelligence-based technologies in spinal surgical decompression. [ABSTRACT FROM AUTHOR]

Objective: To discuss the link between inner ear decompression sickness and patent foramen ovale. Materials and methods: Monocentric and retrospective study on decompression sickness of the inner ear requiring hyperbaric chamber treatment, from 2014 to 2021. Results: Sixty-one patients of inner ear decompression sickness were included in this study. Twenty-four patients had vestibular injuries, 28 cochlear injuries and 9 cochleo-vestibular injuries. Compression chamber treatment was given, using an oxygen–helium mixture with oxygen partial pressure (PIO2) limited to 2.8 atmosphere absolute (ATA). All vestibular accidents completely recovered without clinical sequelae. For cochlear accident only 10 out of 37 patients (27%) recovered completely. A right–left shunt (patent foramen oval or intra-pulmonary shunt) was found in 31.1% of patients with inner ear decompression sickness (p > 0.05). Conclusion: The presence of patent foramen oval in patients with inner ear decompression was not statistically significant in our study. Understanding of the pathophysiology of decompression illness and the physiology and anatomy of the labyrinth would suggest a mechanism of supersaturation with degassing in intra-labyrinthine liquids. [ABSTRACT FROM AUTHOR]

There are many models of lumbar disc degeneration, but mechanical stress-induced lumbar disc degeneration is rare. Here we propose a mechanical stress-induced lumbar disc degeneration model to better understand the molecular mechanism of lumbar disc degeneration under stress stimulation. To design a new model of lumbar disc degeneration under mechanical stress. The anatomic approach of the oblique lateral approach to lumbar fusion surgery was used to design a longitudinal compression device across the vertebral body of the rabbit to impose longitudinal load on the lumbar disc. New Zealand white rabbits (n=30) were used. Screws were used to cross the rabbits' lumbar vertebral bodies, and both sides of the screws were pressurized. Continuous compression was then performed for 28 days. Adjacent unpressurized lumbar discs serve as controls for pressurized lumbar discs. At 28 days after surgery, micro-computed tomography (CT) and magnetic resonance imaging (MRI) were performed on the rabbits' lumbar discs. After the imaging examination, lumbar disc samples were removed, Safranin-O fast green and immunofluorescence was performed to detect the expression level of intervertebral disc degeneration-related proteins. The CT results showed that the disc height did not decrease significantly after mechanical loading. The MRI results showed that the signals in the pressurized disc decreased 28 days after loading. The results of Safranin-O fast green showed that the cartilage component of the intervertebral disc after mechanical compression was significantly reduced. The immunofluorescence results showed that the expression of ADAMTS5 and MMP13 protein in the nucleus pulposus of the intervertebral disc after mechanical compression increased, while the expression of SOX9 decreased, and the difference was statistically significant. Aggrecan's protein expression decreased, but was not statistically significant. This study designed a reliable model of disc degeneration in rabbits. It is more likely to mimic disc compression in the human body. This animal model can be used as a basic model to study the molecular physiological mechanisms of discogenic low back pain. [ABSTRACT FROM AUTHOR]

Background: Despite improvements in drug therapy and treatment of lumbar spinal disorders, dependence on opioid medication for postoperative pain control remains a concern nationwide. This study assessed the ability to diminish the reliance on opioid medication postoperatively with the Food and Drug Administration-approved local anesthetic liposomal bupivacaine in open posterior lumbar decompression and fusion procedures. In addition, the possible effects of this modality on other parameters were studied regarding patients and their recovery. Materials and Methods: A retrospective chart review of 198 patients who underwent an open posterior lumbar laminectomy and fusion surgery with instrumentation treated by a single surgeon in a single institution was conducted. Ninety-nine patients who received liposomal bupivacaine administered intraoperatively were then matched by age, sex, and procedure with the same number of patients treated prior to the availability of liposomal bupivacaine. We evaluated how the use of liposomal bupivacaine affected the requirement for postoperative opioid medication, as well as related changes in length of stay, the use of antiemetics, and urinary retention postoperatively. Results: The patients who received liposomal bupivacaine required less than half of the morphine milligram equivalents of narcotic medications during their hospital stay compared with patients who did not receive liposomal bupivacaine (approximately 57% reduction). Conclusion: The findings of this study suggest that the addition of liposomal bupivacaine to traditional pain management modalities can augment pain management for patients undergoing posterior lumbar surgery, as evidenced by the significant decrease in postoperative morphine milligram equivalents required. [Orthopedics. 2024;47(4):244–248.] [ABSTRACT FROM AUTHOR]

INTRODUCTION: Cabin decompression presents a threat in high-altitude-capable aircraft. A chamber study was performed to compare effects of rapid (RD) vs. gradual decompression and gauge impairment at altitude with and without hypoxia, as well as to assess recovery. METHODS: There were 12 participants who completed RD (1 s) and Gradual (3 min 12 s) ascents from 2743-7620 m (9000-25000 ft) altitude pressures while breathing air or 100% O2. Physiological indices included oxygen saturation (SPO2), heart rate (HR), respiration, end tidal O2 and CO2 partial pressures, and electroencephalography (EEG). Cognition was evaluated using SYNWIN, which combines memory, arithmetic, visual, and auditory tasks. The study incorporated ascent rate (RD, gradual), breathing gas (air, 100% O2) and epoch (ground-level, pre-breathe, ascent-altitude, recovery) as factors. RESULTS: Physiological effects in hypoxic "air" ascents included decreased SPO2 and end tidal O2 and CO2 partial pressures (hypocapnia), with elevated HR and minute ventilation (V̇ E); SPO2 and HR effects were greater after RD (-7.3% lower and +10.0 bpm higher, respectively). HR and V̇ E decreased during recovery. SYNWIN performance declined during ascent in air, with key metrics, including composite score, falling further (-75% vs. -50%) after RD. Broad cognitive impairment was not recorded on 100% O2, nor in recovery. EEG signals showed increased slow-wave activity during hypoxia. DISCUSSION: In hypoxic exposures, RD impaired performance more than gradual ascent. Hypobaria did not comprehensively impair performance without hypoxia. Lingering impairment was not observed during recovery, but HR and V̇ E metrics suggested compensatory slowing following altitude stress. Participants' cognitive strategy shifted as hypoxia progressed, with efficiency giving way to "satisficing," redistributing effort to easier tasks. [ABSTRACT FROM AUTHOR]

This study aimed to explore the application effects of cluster process control and routine nursing on the prevention of pressure injury (PI) in patients undergoing head and neck cancer surgery and to provide a basis for reducing the occurrence of PI, thereby promoting the safety of the patients. This was a retrospective study. Patients with head and neck cancers who underwent surgical treatment in the Department of Otolaryngology at the Second Affiliated Hospital of Fujian Medical University from July 2022 to June 2023 were selected as the research participants. Participants were classified into experimental and control groups using a convenience sampling method. In the experimental group, cluster process control was implemented, while routine nursing management was applied in the control group. The incidence of PI (p = 0.028) and healing time (p = 0.035) in the experimental group were lower than those in the control group. The process management ability of nurses in the experimental group was significantly improved, with the results for the Braden scale (p = 0.023), effective decompression (p = 0.002), floating heel (p = 0.002), nutrition monitoring (p = 0.005), and patient satisfaction in the experimental group being higher than those in the control group (p = 0.007). This study effectively demonstrated the effect of cluster process control in reducing the incidence of PI in patients undergoing head and neck cancer surgery, thereby determining that cluster process control is suitable for clinical application. [ABSTRACT FROM AUTHOR]

Introduction: Trauma-induced hemorrhage is a leading cause of death in prehospital settings. Experimental data demonstrate that females have a lower tolerance to simulated hemorrhage (i.e., central hypovolemia). However, the mechanism(s) underpinning these responses are unknown. Therefore, this study aimed to compare autonomic cardiovascular responses during central hypovolemia between the sexes. We hypothesized that females would have a lower tolerance and smaller increase in muscle sympathetic nerve activity (MSNA) to simulated hemorrhage. Methods: Data from 17 females and 19 males, aged 19-45 yr, were retrospectively analyzed. Participants completed a progressive lower-body negative pressure (LBNP) protocol to presyncope to simulate hemorrhagic tolerance with continuous measures of MSNA and beat-to-beat hemodynamic variables. We compared responses at baseline, at two LBNP stages (-40 and -50 mmHg), and at immediately before presyncope. In addition, we compared responses at relative percentages (33%, 66%, and 100%) of hemorrhagic tolerance, calculated via the cumulative stress index (i.e., the sum of the product of time and pressure at each LBNP stage). Results: Females had lower tolerance to central hypovolemia (female: 561 ± 309 vs male: 894 ± 304 min⋅mmHg [time⋅LBNP]; P = 0.003). At LBNP -40 and -50 mmHg, females had lower diastolic blood pressures (main effect of sex: P = 0.010). For the relative LBNP analysis, females exhibited lower MSNA burst frequency (main effect of sex: P = 0.016) accompanied by a lower total vascular conductance (sex: P = 0.028; main effect of sex). Conclusions: Females have a lower tolerance to central hypovolemia, which was accompanied by lower diastolic blood pressure at -40 and -50 mmHg LBNP. Notably, females had attenuated MSNA responses when assessed as relative LBNP tolerance time. [ABSTRACT FROM AUTHOR]

Background Arterial compression of the trigeminal nerve at the root entry zone has been the long-attributed cause of compressive trigeminal neuralgia despite numerous studies reporting distal and/or venous compression. The impact of compression type on patient outcomes has not been fully elucidated. Objective We categorized vascular compression (VC) based on vessel and location of compression to correlate pain outcomes based on compression type. Methods A retrospective video review of 217 patients undergoing endoscopic microvascular decompression for trigeminal neuralgia categorizing VC into five distinct types, proximal arterial compression (VC1), proximal venous compression (VC2), distal arterial compression (VC3), distal venous compression (VC4), and no VC (VC5). VC type was correlated with postoperative pain outcomes at 1 month (n = 179) and last follow-up (mean = 42.9 mo, n = 134). Results At 1 month and longest follow-up, respectively, pain was rated as "much improved" or "very much improved" in 89 69% of patients with VC1, 86.6 and 62.5% of patients with VC2, 100 and 87.5% of patients with VC3, 83 and 62.5% of patients with VC4, and 100 and 100% of patients with VC5. Multivariate analysis demonstrated VC4 as a significant negative of predictor pain outcomes at 1 month, but not longest follow-up, and advanced age as a significant positive predictor. Conclusion The degree of clinical improvement in all types of VC was excellent, but at longest follow-up VC type was not a significant predictor out outcome. However distal venous compression was significantly associated with worse outcomes at 1 month. [ABSTRACT FROM AUTHOR]

Background: Crush Syndrome (CS), a severe trauma resulting from prolonged muscle compression, is commonly seen in large-scale disasters such as earthquakes. It not only causes localized tissue damage but also triggers electrolyte imbalances, particularly hyperkalemia, increasing the risk of early mortality. This study aims to assess the early intervention effects of Sodium Zirconium Cyclosilicate (SZC) on hyperkalemia in rat CS model. Methods: A rat CS model was established using a self-developed multi-channel intelligent small-animal crush injury platform. Rats in the experimental groups were treated with varying doses of SZC before compression and immediately post-decompression. The efficacy of SZC was evaluated by continuous monitoring of blood potassium levels and survival rates. Serum creatinine (Cre) and blood urea nitrogen (BUN) levels were analyzed, and renal damage was assessed through histopathological examination. Results: SZC treatment significantly reduced blood potassium levels and improved survival rates in rats. Compared to the placebo group, the SZCtreated rats showed a significant decrease in blood potassium levels at 6 and 12 h post-decompression, maintaining lower levels at 24 h. Biochemical analysis indicated no significant impact of SZC on renal function, with no notable differences in Cre and BUN levels between groups. Histopathological findings revealed similar levels of renal damage in both groups. Conclusion: SZC demonstrates significant early intervention effects on hyperkalemia in a rat model of crush injury, effectively improving survival rates without adverse effects on renal function. These results provide a new strategic direction for the clinical treatment of Crush Syndrome and lay the foundation for future clinical applications. [ABSTRACT FROM AUTHOR]

Introduction: Diving decompression theory hypothesizes inflammatory processes as a source of micronuclei which could increase related risks. Therefore, we tested 10 healthy, male divers. They performed 6–8 dives with a maximum of two dives per day at depths ranging from 21 to 122 msw with CCR mixed gas diving. Methods: Post-dive VGE were counted by echocardiography. Saliva and urine samples were taken before and after each dive to evaluate inflammation: ROS production, lipid peroxidation (8-iso-PGF2), DNA damage (8-OH-dG), cytokines (TNF-α, IL-6, and neopterin). Results: VGE exhibits a progressive reduction followed by an increase (p < 0.0001) which parallels inflammation responses. Indeed, ROS, 8-iso-PGF2, IL-6 and neopterin increases from 0.19 ± 0.02 to 1.13 ± 0.09 μmol.min−1 (p < 0.001); 199.8 ± 55.9 to 632.7 ± 73.3 ng.mg−1 creatinine (p < 0.0001); 2.35 ± 0.54 to 19.5 ± 2.96 pg.mL−1 (p < 0.001); and 93.7 ± 11.2 to 299 ± 25.9 μmol·mol−1 creatinine (p = 0.005), respectively. The variation after each dive was held constant around 158.3% ± 6.9% (p = 0.021); 151.4% ± 5.7% (p < 0.0001); 176.3% ± 11.9% (p < 0.0001); and 160.1% ± 5.6% (p < 0.001), respectively. Discussion: When oxy-inflammation reaches a certain level, it exceeds hormetic coping mechanisms allowing second-generation micronuclei substantiated by an increase of VGE after an initial continuous decrease consistent with a depletion of “first generation” pre-existing micronuclei. [ABSTRACT FROM AUTHOR]

Objective The aim this study is to present the results of the minimal invasive neuroendoscopic-assisted system application as an alternative to traditional surgery in patients with Chiari malformation type 1 (CM type 1) with/without syringomyelia. Design, Setting, and Participants In the study, data of 22 symptomatic patients were prospectively collected. Before and after the operation, patient characteristics, computed tomography, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) flow dynamics MRI, and outcome scales scores were recorded. Foramen magnum decompression and C1 total laminectomy were performed. The fibrous band at the craniocervical junction was opened and a durotomy was performed. In patients with a syrinx, the pre- and postoperative axial and sagittal lengths of the syrinx were measured and compared. Results The mean age of the patients was 32 ± 5 years. There were eight male patients. Ten patients had syrinx. The mean visual analog scale (VAS) score before and after surgery was 8 ± 1.06 and 2.18 ± 1.13, respectively. When evaluated according to the Chicago Chiari Outcome Scale, there was improvement in 20 patients, while there was no change in 2 patients. Syrinx resolved completely in 3 of 10 (13.6%) patients with syringomyelia, and the syrinx volume decreased in 3 patients (13.6%). In 4 of 10 (18.1%) patients, there was no significant change in the syrinx volume. The average operation time was 105 minutes (80–150 minutes). The average blood loss was 40 mL (20–110 mL). Conclusion Although the study was limited due to the small number of patients with a short follow-up, endoscopic decompression was a safe and effective technique for surgery in CM type 1 patients. [ABSTRACT FROM AUTHOR]

Decompression sickness (DCS) is caused by gaseous nitrogen dissolved in tissues forming bubbles during decompression. To date, no method exists to identify nitrogen within tissues, but with advances in positron-emission tomography (PET) technology, it may be possible to track gaseous radionuclides into tissues. We aimed to develop a method to track nitrogen movement in vivo and under hyperbaric pressure that could then be used to further our understanding of DCS using nitrogen-13 (13N2). A single anesthetized female Sprague–Dawley rat was exposed to 625 kPa, composed of air, isoflurane, and 13N2 for 10 min. The PET scanner recorded 13N2 during the hyperbaric exposure with energy windows of 250–750 keV. The PET showed an increase in 13N2 concentration in the lung, heart, and abdominal regions, which all reached a plateau after ∼4 min. This showed that it is possible to gain noninvasive in vivo measurements of nitrogen kinetics through the body while at hyperbaric pressures. Tissue samples showed radioactivity above background levels in the blood, brain, liver, femur, and thigh muscle when assessed using a γ counter. The method can be used to evaluate an array of challenges to our understanding of decompression physiology by quantifying nitrogen load through γ counts of 13N2, and signal intensity of the PET. Further development of the method will improve the specificity of the measured outcomes, and enable it to be used with larger mammals, including humans. NEW & NOTEWORTHY: This article describes a method for the in vivo quantification and tracking of nitrogen through the mammalian body whilst exposed to hyperbaric pressure. The method has the potential to further our understanding of decompression sickness, and quantitatively evaluate the effectiveness of both the treatment and prevention of decompression sickness. [ABSTRACT FROM AUTHOR]

Highly valued for their nutritional benefits, sprouts are characterized by high water content, which promotes microbial proliferation, potentially leading to toxicity and a reduced shelf life. To address this challenge, the present study explores the application of a novel drying–texturizing approach, named IVDV (Intensification of Vaporization by Decompression to the Vacuum), to sprouts. This technique would enable faster drying of the sprouts and better preservation of their nutritional content, compared to traditional hot-air drying. Using Response Surface Methodology, optimal IVDV parameters (saturated steam pressure P, processing time t, and water content W) for wheat sprouts were defined, with a focus on preserving vitamins, proteins, and lipids, and optimizing the expansion ratio. This optimization process identified optimal experimental conditions at 5.5 bars, a duration of 15 s, and 8.8% d.b. water content. Under these conditions, the use of IVDV endowed the expanded sprouts with a crunchier and more friable texture. In addition, it significantly improved the preservation of vitamins B6 and E by 412% and 42%, respectively, compared to traditional mild hot-air drying, without significantly affecting vitamin B2, proteins, and lipids. When combined with conventional hot-air drying, IVDV not only enhanced the preservation of the sprouts' nutritional content but also reduced drying time and energy consumption. This marks a significant advancement in sprouts preservation techniques, paving the way for novel potential applications. [ABSTRACT FROM AUTHOR]

In the context of China's rapid development and accelerated pace of life, people generally face increased pressure, leading to a sharp increase in psychological problems. More than half of the population is sub‐healthy, and patients with mental illness are also increasing year by year. Mental stress is a common cause of psychological and physiological disorders, triggering emergency stress states. Psychotherapy has been developing as an important intervention method, and psychological relief based on relaxation and stress reduction has gradually become a research hotspot. Behavioral therapy and cognitive therapy are common psychological treatments, while relaxation induction methods include breathing training, meditation, music, etc. Virtual reality technology is used in psychological research to improve therapeutic effects. Among them, virtual reality exposure therapy (VRET), which treats anxiety by creating virtual scenes, has attracted attention. And in virtual reality exposure therapy treatment, the patient's psychological state can be grasped by monitoring these physiological reactions. This article will discuss the key technologies for psychological decompression based on VRET, aiming to gain an in‐depth understanding of its principles, applications, etc. [ABSTRACT FROM AUTHOR]

Background: Subacromial spurs are considered the one of the pathology underlying shoulder impingement syndrome. Furthermore, few studies have focused on the morphology of the subacromial spurs in normal Chinese people. This study aimed to study the spur distribution and to illustrate the morphology of spurs, which may help guide the extent of acromioplasty. Methods: A total of 93 normal individuals were enrolled, and both shoulders of all enrolled individuals were analyzed. The subjects were divided and classified into three different groups by ages: group I = 18–40 years, group II = 41–60 years, and group III ≥ 61 years. The osteophyte distribution, osteophyte area, subacromial surface area and osteophyte area/subacromial surface area ratio were measured and illustrated using Mimics and 3-matic software. The shape of the acromion was classified according to the Bigliani and Morrison classification system. The acromial angle was also classified. Then, the relationship between osteophytes, acromial classification and acromial angle was analyzed. Results: Type II (curved shape) was the most common type of acromion, and the hooked shape was a rare form. A significant increase in the left subacromial surface area in males was observed in group III compared with group I (P < 0.001) and group II (P = 0.004). The total spur/subacromial area ratio was significantly higher in group II than I. An obvious increase in the right subacromial area was observed in group III compared with group I (P = 0.004). Furthermore, there was a significant increase in the right spur area (P = 0.021) and total spur/subacromial area ratio (P = 0.006) in females in group II compared with group I. Fewer spurs were observed on the left than on the right side (p = 0.0482). One spur was most common among type II acromions (29/36) (80.56%) on the left side and the right side (34/52, 65.38%). Conclusions: Spurs osteophytes are mainly distributed with an irregular shape and mostly run through the medial and lateral sides of the subacromial surface in normal subjects. The characteristics of subacromial spurs are so diverse that a surgeon must conduct subacromial decompression completely based on the morphology of individual spurs. [ABSTRACT FROM AUTHOR]

Reoperation, sometimes multiple, is common with progressively worse outcomes in patients with degenerative lumbar spine diseases. Lysophosphatidylcholine (LPC), a precursor of lysophosphatidic acid, in the cerebrospinal fluid (CSF) is a possible biomarker for neuropathic pain and discriminating neuropathic pain caused by lumbar spinal canal stenosis (LSCS) from other etiologies. This study aimed to explore this possible use of LPC species in the CSF. Patients with LSCS (n = 137) and persistent spinal pain syndrome (n = 22) were subjected in this multi-site observational study. The CSF was collected by lumbar puncture. Using liquid chromatography-tandem mass spectrometry, we measured 6 LPC species, (16:0), (18:0), (18:1), (18:2), (20:4), and (22:6), in the CSF. We compared the LPC values between the groups and determined the cutoff levels that could efficiently discriminate the groups with high accuracy. The levels of all measured LPC species were significantly higher in the LSCS group than the persistent spinal pain syndrome group. Four LPC species demonstrated more than 0.80 area under the curve obtained from the receiver operating characteristic curve analysis. Although the specificity of cutoff levels for the 6 LPC species was low to moderate, their sensitivity was consistently high. The existing diagnostic protocols combining physical examinations and morphological imaging studies for lumbar spinal pain have limited sensitivity. Measuring LPC species in the CSF is a promising objective laboratory test and could be suitable for detecting the presence of lumbar spinal stenosis and can help indications for surgery. [ABSTRACT FROM AUTHOR]

Underwater activities are characterized by an imbalance between reactive oxygen/nitrogen species (RONS) and antioxidant mechanisms, which can be associated with an inflammatory response, depending on O2 availability. This review explores the oxidative stress mechanisms and related inflammation status (Oxy-Inflammation) in underwater activities such as breath-hold (BH) diving, Self-Contained Underwater Breathing Apparatus (SCUBA) and Closed-Circuit Rebreather (CCR) diving, and saturation diving. Divers are exposed to hypoxic and hyperoxic conditions, amplified by environmental conditions, hyperbaric pressure, cold water, different types of breathing gases, and air/non-air mixtures. The "diving response", including physiological adaptation, cardiovascular stress, increased arterial blood pressure, peripheral vasoconstriction, altered blood gas values, and risk of bubble formation during decompression, are reported. [ABSTRACT FROM AUTHOR]

This article, published in the Journal of Neurological Surgery, describes a case study of a 60-year-old woman with a large unruptured clinoidal-ophthalmic segment aneurysm. The patient underwent a specific surgical procedure called the "Dallas Technique," which involved an orbitopterional craniotomy, anterior clinoidectomy, and retrograde suction decompression. The article provides technical details about the suction decompression technique used to treat giant paraclinoid aneurysms. The authors of the article are Kara A. Parikh, Vincent N. Nguyen, Eva Wu, Adam S. Arthur, L. Madison Michael, and Nickalus R. Khan. [Extracted from the article]

Microvascular decompression for trigeminal neuralgia is typically performed with placement of Teflon to separate the offending artery and trigeminal nerve. However, recurrence of symptoms may occur over time due to granuloma formation, overpacking, or Teflon contraction. Here, we present two cases involving vessel transposition using a pericranial sling or sling-less technique. These techniques allow for complete decompression of the trigeminal nerve without the need for permanent implantation of a foreign body.By Ramin Morshed and Edward ChangReported by Author; Author [Extracted from the article]

This article discusses the management of hypophysitis, a rare and challenging inflammatory disorder. The study analyzed data from 12 adult patients with hypophysitis, examining their demographics, treatment modalities, laboratory findings, histopathological results, and radiological images. The results showed that corticosteroid therapy is the main treatment strategy, but diagnostic accuracy remains difficult due to the wide range of imaging findings. Younger patients have a higher risk of recurrence, and controlling blood glucose levels and body mass index is important in preventing recurrence. Surgical intervention can confirm the diagnosis and improve symptoms, and radiation therapy may be effective for resistant cases. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, examines the surgical management and long-term outcomes of Rathke's cleft cysts (RCCs). RCCs are nonneoplastic cysts that are typically asymptomatic, but when symptoms arise, surgical decompression is performed. The study reviewed 32 cases of RCC decompression and found that while most patients experienced improvement in visual field defects, there were complications such as endocrinological deterioration and cyst recurrence. The authors recommend that surgery for RCC should be approached with caution. [Extracted from the article]

This article discusses the importance of complete closure of the dura to prevent cerebrospinal fluid (CSF) leakage in microvascular decompression (MVD) surgery. The authors present a new three-step dural suture technique called the "Triple Layer Closing Technique" that was used in 475 MVD surgeries. The technique involves using Duragen, TachoSil, and polymethyl methacrylate (PMMC) bone cement to achieve a watertight suture. The study found that CSF leakage occurred in 1.1% of patients, but all cases were successfully treated without reoperation. The authors conclude that the triple-layer closing technique is a secure method for preventing complications in MVD surgery. [Extracted from the article]

The article discusses the anterior petrosal approach (APA) as a surgical technique for the resection of petroclival meningiomas (PCM) and the relief of trigeminal neuralgia. The APA involves removing the petrous bone and opening the porus trigeminus to access the tumor and decompress the trigeminal nerve. The study analyzed five cases of PCM that underwent APA surgery, achieving near-total resection in three cases and subtotal resection in two cases. The article emphasizes the importance of understanding skull base anatomy, surgical skills, and preoperative imaging for successful APA surgery. Overall, the APA is considered an effective technique for managing PCM and relieving trigeminal neuralgia. [Extracted from the article]

This article describes a rare case of trigeminal neuralgia (TN) caused by compression on the trigeminal sensory nucleus and tract by an aberrant dual anastomotic artery loop. The patient, a 74-year-old male, experienced progressive episodic pain in the left forehead, eyelid, cheek, and jaw. Brain MRI revealed compression on the pons near the fourth ventricle caused by the left posterior inferior cerebellar artery (PICA) and an anastomotic loop connecting the anterior inferior cerebellar artery (AICA) and PICA. The patient underwent endoscopic-assisted microvascular decompression (MVD), which successfully relieved the pain. The article discusses the vulnerability of the trigeminal nerve to vascular forces and the effectiveness of MVD in reversing microstructural changes. It also highlights the need for further research on the mechanism and treatment of TN caused by vascular compression. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, discusses a case study of a 53-year-old female who presented with left facial pain and numbness. MRI revealed a mass in Meckel's cave, which was causing compression of the trigeminal nerve. The patient opted for surgery, and a middle fossa anterior petrosectomy approach was used to decompress the trigeminal ganglion and resect the tumor. The surgery was successful in relieving the patient's pain and improving facial numbness. The article provides valuable insights into the treatment options for this condition. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, discusses the treatment of trigeminal neuralgia (TN) caused by meningiomas involving Meckel's cave. The study analyzed the outcomes of microsurgery in patients with PC meningiomas who experienced severe TN. The results showed that 80% of patients experienced improvement in TN symptoms after microsurgery and were able to discontinue medication. The study concludes that microsurgery is an effective treatment option for TN patients, particularly when stereotactic radiosurgery is ineffective. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, explores the use of a random forest algorithm to predict functional outcomes following microvascular decompression (MVD) for trigeminal neuralgia (TN). TN is a painful disorder caused by blood vessel compression, and MVD is considered the most effective treatment. The study reviewed 225 cases of TN and trained a random forest algorithm to predict postoperative pain outcomes. The algorithm demonstrated 88% accuracy in predicting average postoperative pain, with sleep and mood found to be important predictors. The study highlights the potential of machine learning in identifying meaningful associations for rare conditions like TN. [Extracted from the article]

This article discusses the role of early optic nerve decompression in the transcranial resection of tuberculum sellae meningiomas. Meningiomas are common brain tumors that often cause vision loss due to involvement of the optic canal. The optimal approach for resection depends on the extent of vascular encasement, with the transsphenoidal approach being safer in the absence of extensive vascular encasement. However, previous studies have suggested that the endoscopic endonasal approach (EEA) may offer better visual outcomes. The authors hypothesize that the timing of optic nerve decompression, rather than the approach itself, may be the determining factor. They review a series of 20 patients who underwent transcranial resection with upfront optic nerve decompression and found that 45% of patients had improved vision post-operatively. The authors suggest that early optic nerve decompression may be protective in patients who require a transcranial approach. [Extracted from the article]

Background: Recently, we developed a chest compression device that can move the chest compression position without interruption during CPR and be remotely controlled to minimize rescuer exposure to infectious diseases. The purpose of this study was to compare its performance with conventional mechanical CPR device in a mannequin and a swine model of cardiac arrest. Materials and methods: A prototype of a remote-controlled automatic chest compression device (ROSCER) that can change the chest compression position without interruption during CPR was developed, and its performance was compared with LUCAS 3 in a mannequin and a swine model of cardiac arrest. In a swine model of cardiac arrest, 16 male pigs were randomly assigned into the two groups, ROSCER CPR (n = 8) and LUCAS 3 CPR (n = 8), respectively. During 5 minutes of CPR, hemodynamic parameters including aortic pressure, right atrial pressure, coronary perfusion pressure, common carotid blood flow, and end-tidal carbon dioxide partial pressure were measured. Results: In the compression performance test using a mannequin, compression depth, compression time, decompression time, and plateau time were almost equal between ROSCER and LUCAS 3. In a swine model of cardiac arrest, coronary perfusion pressure showed no difference between the two groups (p = 0.409). Systolic aortic pressure and carotid blood flow were higher in the LUCAS 3 group than in the ROSCER group during 5 minutes of CPR (p < 0.001, p = 0.008, respectively). End-tidal CO2 level of the ROSCER group was initially lower than that of the LUCAS 3 group, but was higher over time (p = 0.022). A Kaplan-Meier survival analysis for ROSC also showed no difference between the two groups (p = 0.46). Conclusion: The prototype of a remote-controlled automated chest compression device can move the chest compression position without interruption during CPR. In a mannequin and a swine model of cardiac arrest, the device showed no inferior performance to a conventional mechanical CPR device. [ABSTRACT FROM AUTHOR]

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Objective: The aim of this study was to compare the results of microdiskectomy + fusion and microdiskectomy + dynamic instrumentation, which are 2 different methods used for treating upper-level lumbar disk herniations, and to share the data obtained with our colleagues. Materials and Methods: In this study, 51 patients who underwent surgery for upper-level disk herniation between 2019 and 2021 were retrospectively analyzed. The study group was divided into two groups. Patients who underwent microdiscectomy with fusion and those who underwent microdiscectomy with dynamic instrumentation were examined. In both groups, demographic data, such as age and gender, as well as quality of life scores, such as preoperative visual pain scoring and Oswestry disability index, etc. were examined and compared with the postoperative values at the end of 1 year. Complications were noted. Results: There was no significant difference between both groups in terms of gender and age distribution (p=0.676, p=0.992). After 1 year of follow-up, both groups showed significant improvement in both the back-leg visual pain score and Oswestry disability values. When back-leg visual pain and Oswestry disability score change between the groups were analyzed, there was no significant difference in terms of pain, whereas Oswestry disability change was better in the fusion group (p=0.76, p=0.354, p=0.037 respectively). Complications were observed in 7 (13.7%) patients, and superficial wound infection was the most common complication in five (71.4%) patients. Dural tears and hematomas were detected in one patient each. None of the patients required revision surgery. Conclusion: Both techniques can be used for treating upper-level disk herniations. After one year of follow-up, we believe that there is no significant difference between the two groups, although the fusion group appears to be superior in terms of ODI recovery. [ABSTRACT FROM AUTHOR]

The residual oil saturation of the matrix near the well zone of a tight reservoir is high due to the tight reservoir's complex conditions, such as the small pore throat radius and low permeability of the matrix and the development of microfractures, which can result in serious water channeling, even after long-term water injection development. The aim of this paper is to improve the effects of depressurization and augmented injection for tight reservoir waterflooding development by reducing the tight matrix's residual oil saturation, increasing and maintaining its water phase permeability near the well zone using a nano-SiO2 microemulsion system with a small particle size and high interfacial activity. Therefore, four nano-microemulsion systems were evaluated and screened for their temperature resistance, salt resistance, interfacial tension, solubilization, and dilution resistance. A microemulsion system of 13% A + 4% B + 4% C + 4% n-butanol + 6% oil phase + 69% NaCl solution (10%) + 1% OP-5 + 0.5% anti-temperature agent + 0.3% nanosilica material was preferred. According to the core displacement experiment, the depressurization rate can reach 28~60% when the injection concentration of the system is 1~10% and the injection volume is 2~5 PV. The results of the on-site test show that the water injection pressure dropped to 17.5 MPa, which was lower than the reservoir fracture re-opening pressure. The pressure reduction rate was approximately 20%. The validity period of the depressurization and augmented injection has reached 23 months to date. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Engineering Research & Development (IJERAD) is the property of International Journal of Engineering Research & Development and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Conus medullaris syndrome (CMS) is a distinctive spinal cord injury (SCI), which presents with varying degrees of upper motor neuron signs (UMNS) and lower motor neuron signs (LMNS). Herein, we present a case with a burst fracture injury at the proximal Conus Medullaris (CM). Case Presentation: A 48-year-old Taiwanese male presenting with lower back pain and paraparesis was having difficulty standing independently after a traumatic fall. An Imaging survey showed an incomplete D burst fracture of the T12 vertebra. Posterior decompression surgery was subsequently performed. However, spasticity and back pain persisted for four months after surgical intervention. Follow-up imaging with single photon emission computed tomography (SPECT) and a whole body bone scan both showed an increased uptake in the T12 vertebra. Conclusion: The high-riding injury site for CMS is related to a more exclusive clinical representation of UMNS. Our case's persistent UMNS and scintigraphy findings during follow-up showcase the prolonged recovery period of a UMN injury. In conclusion, our study provides a different perspective on approaching follow-up for CM injuries, namely using scientigraphy techniques to confirm localization of persistent injury during the course of post-operative rehabilitation. Furthermore, we also offered a new technique for analyzing the location of lumbosacral injuries, and that is to measure the location of the injury relative to the tip of the CM. This, along with clinical neurological examination, assesses the extent to which the UMN is involved in patients with CMS, and is possibly a notable predictive tool for clinicians for the regeneration time frame and functional outcome of patients with lumbosacral injuries in the future. [ABSTRACT FROM AUTHOR]

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To compare outcomes after oblique lateral interbody fusion (OLIF) versus minimally invasive transforaminal lumbar interbody fusion (MISTLIF) with bilateral decompression via unilateral approach for treating mild to moderate symptomatic degenerative lumbar spinal stenosis (DLSS). We retrospectively compared patients who underwent single-level (L4/5) OLIF with an age-, sex-, and segment-matched MISTLIF with bilateral decompression via unilateral approach cohort. Perioperative data were collected for the operative time, intraoperative blood loss, drainage in the first postoperative day, postoperative hospital stay, cost, intraoperative fluoroscopy, and complications. Lumbar radiographs were measured for changes in posterior intervertebral space height (PISH), intervertebral space foramen height (IFH), intervertebral foramen area (IFA), and area of the spinal canal (ASC). Clinical and psychological outcomes included the visual analog scale (VAS), Oswestry Disability Index (ODI), and hospital anxiety and depression scale (HADS). 35 OLIF patients were compared with 35 MISTLIF patients in L4/5 DLSS. The OLIF group had shorter bedtime, postoperative hospital stays, less intraoperative and postoperative blood loss (all P < 0.05), but had more times of intraoperative fluoroscopy, longer operative time, and higher cost (all P < 0.05). The complication rates were equivalent (OLIF vs MISTLIF: 22.86% vs 17.14%). PISH (11.94 ± 1.78 mm vs 9.42 ± 1.94 mm, P < 0.05), IFH (23.87 ± 3.05 mm vs 21.41 ± 2.95 mm, P < 0.05), and IFA (212.14 ± 51.82 mm2 vs 177.07 ± 51.73 mm2, P < 0.05) after surgery were significantly increased in the OLIF group. The ASC was increased significantly after the operation in both groups, but the ASC in the MISTLIF group was increased significantly more than that in the OLIF group (450.04 ± 66.66 mm2 vs 171.41 ± 58.55 mm2, P < 0.05). The lumbar VAS scores at 1 month (1.89 ± 0.87 vs 2.34 ± 0.84, P = 0.028) and 6 months (1.23 ± 0.97 vs 1.80 ± 0.99, P = 0.018) after operation in the OLIF group were significantly lower. There were no significant differences in lower extremity VAS and ODI scores between the two groups. Compared with MISTLIF group, HADS scores on postoperative day 3 (2.91 ± 1.46 vs 4.89 ± 1.78, P < 0.05) and prior to hospital discharge (PTD) (2.54 ± 1.38 vs 3.80 ± 1.78, P = 0.002) in the OLIF group were decreased significantly. OLIF showed more advantages of less surgical invasion, lower incidence of postoperative low back pain, faster postoperative recovery, and less anxiety compared with MISTLIF. Regardless of cost, OLIF seems to be a better option to treat mild to moderate symptomatic DLSS. [ABSTRACT FROM AUTHOR]

Osteopathia striata combined with cranial sclerosis (OS-CS) is an inherited skeletal dysplasia that manifests with macrocephaly, orofacial abnormalities, thickened craniofacial bones, and vertically oriented radiodensities of the long bones. Here, we present a severe case of OS-CS in a 4-year-old girl causing optic neuropathy as shown by radiographic evidence, ophthalmic findings, and histopathology. Previous genetic testing in this patient revealed a de novo heterozygous mutation in AMER1 (c.1057C>T, p.Arg353Ter). Although the patient had a pre-existing, appropriately functioning, ventriculoperitoneal (VP) shunt, a subsequent MRI of the brain and orbits showed narrowing of the bilateral optic nerve canals secondary to osseous thickening causing bilateral optic nerve atrophy, worse on the left. The patient underwent staged bilateral orbital osteotomies, optic canal decompression, and bilateral frontal craniotomy, and at 11 months postoperatively, her vision remained stable. Conclusions: While up to 50% of the patients with OS-CS may experience hearing loss due to cranial nerve compression, we present a case of severe visual loss secondary to OS-CS-associated optic nerve compression. [ABSTRACT FROM AUTHOR]

INTRODUCTION: C onsistent blood biomarkers of hypobaric (altitude) decompression stress remain elusive. Recent laboratory investigation of decompression sickness risk at 25,000 ft (7620 m) enabled evaluation of early pathophysiological responses to exertional decompression stress. METHODS: In this study, 15 healthy men, aged 20-50 yr, undertook 2 consecutive (same-day) ascents to 25,000 ft (7620 m) for 60 and 90 min, breathing 100% oxygen, each following 1 h of prior denitrogenation. Venous blood was sampled at baseline (T0), immediately after the second ascent (T8), and next morning (T24). Analyses encompassed whole blood hematology, endothelial microparticles, and soluble markers of cytokine response, endothelial function, inflammation, coagulopathy, oxidative stress, and brain insult, plus cortisol and creatine kinase. RESULTS: A cute hematological effects on neutrophils (mean 72% increase), eosinophils (40% decrease), monocytes (37% increase), and platelets (7% increase) normalized by T24. Consistent elevation (mean five-fold) of the cytokine interleukin-6 (IL-6) at T8 was proinflammatory and associated with venous gas emboli (microbubble) load. Levels of C-reactive protein and complement peptide C5a were persistently elevated at T24, the former by 100% over baseline. Additionally, glial fibrillary acidic protein, a sensitive marker of traumatic brain injury, increased by a mean 10% at T24. CONCLUSIONS: This complex composite environmental stress, comprising the triad of hyperoxia, decompression, and moderate exertion at altitude, provoked pathophysiological changes consistent with an IL-6 cytokine-mediated inflammatory response. Multiple persistent biomarker disturbances at T24 imply incomplete recovery the day after exposure. The elevation of glial fibrillary acidic protein similarly implies incomplete resolution following recent neurological insult. [ABSTRACT FROM AUTHOR]

BACKGROUND: French-door laminoplasty is a commonly used procedure for the treatment of cervical multi-segment degenerative myelopathy. At present, the prediction and control of the intraoperative opening angle need further improvement. OBJECTIVE: To compare the opening angle and clinical outcomes of two different hinge rongeurs in the cervical French-door laminoplasty. METHODS: Data of 57 cervical multi-segment degenerative myelopathy patients in Seventh Affiliated Hospital of Sun Yat-sen University and First Affiliated Hospital of Sun Yat-sen University from June 2018 to June 2020 were retrospectively analyzed. The patients were divided into 20° rongeur group (n=31) and 15° rongeur group (n=26). Comparative study was made to find out the differences in functional outcomes (modified Japanese Orthopaedic Association score and visual analogue scale score), radiological outcomes (lamina angle, sagittal diameter of spinal canal, and hinge healing), and postoperative complications (axial symptoms and C5 nerve root paralysis). RESULTS AND CONCLUSION: (1) There was no significant difference in postoperative modified Japanese Orthopaedic Association score and postoperative visual analogue scale score between the two groups. (2) The postoperative lamina angles of the two groups were significantly higher than the preoperative lamina angles (P < 0.01). Among them, the postoperative lamina angle of the 15° hinge group (62.74±7.62)° was significantly smaller than that of the 20° hinge group (68.55±8.71)° (P < 0.01). The sagittal diameter of spinal canal of 15° rongeur group (13.52±2.16) mm was significantly lower than that of the 20° rongeur group (15.39±2.85) mm (P < 0.01). (3) At 4 weeks after operation, the fusion rate of the hinge in the 15° rongeur group was significantly higher than that of the 20° rongeur group (49%, 35%, P < 0.01). (4) There was no significant difference in the incidence of postoperative complications between the two groups. (5) It is indicated that when the hinge rongeur is used, the opening angle can be predicted before the operation and accurately controlled during the operation. Compared with the 20° hinge rongeur, using the 15° hinge rongeur to make the hinge can expand the lamina angle about 25° and reach about 63° after operation, avoiding the opening angle and the sagittal diameter of the spinal canal being too large. Both the 15° hinge rongeur and the 20° hinge rongeur can achieve satisfactory decompression effect, but the hinge healing time in the 15° hinge rongeur group is shorter, which is beneficial to the recovery of postoperative neurological function. [ABSTRACT FROM AUTHOR]

Elderly people usually have poorer surgical tolerance and a higher incidence of complications when undergoing revision surgery after posterior instrumented lumbar fusion (PILF). Full-endoscopic transforaminal surgery is a safe and effective option, but sometimes, it is difficult to revise L5-S1 foraminal stenosis (FS) after PILF. Therefore, we developed full-endoscopic lumbar decompression (FELD) at the arthrodesis level via a modified interlaminar approach under local anesthesia. This study aimed to describe the technical note and clinical efficacy of the technique. Eleven patients with unilateral lower limb radiculopathy after PILF underwent selective nerve root block and then underwent FELD. Magnetic resonance imaging (MRI) and computer tomography (CT) were performed on the second postoperative day. Their clinical outcomes were evaluated with a Visual analog scale (VAS) of low back pain and sciatica pain, Oswestry disability index (ODI), and the MacNab score. Complete decompression was achieved in every case with FELD without serious complications. Postoperative VAS of sciatica pain and ODI at each time point and VAS of low back pain and ODI after three months postoperatively were significantly improved compared with those preoperative (p < 0.05). According to the MacNab criteria, seven patients (63.6%) had excellent results at the two-year follow-up, and four patients (36.4%) had good results. No patients required further revision surgery. FELD, via a modified interlaminar approach, is effective for treating unilateral L5-S1 FS after PILF in elderly people. [ABSTRACT FROM AUTHOR]

Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective This article describes a novel technique for trigeminal nerve decompression in the setting of refractory trigeminal neuralgia (TN). Design Technical note with an illustrative case example and operative video. Setting Outpatient, inpatient, and operating room of a quaternary neurosurgical referral center. Participant A woman in her early 70s who had previously undergone linear accelerator-based stereotactic radiotherapy (i.e., CyberKnife) and achieved 2 years of partial pain relief. However, facial pain, numbness, and parasympathetic dysfunction returned and became unbearable. Main Outcome Measure Durable relief of TN. Results Microvascular decompression was recommended for refractory TN. Intraoperatively, the trigeminal nerve was markedly attenuated from previous irradiation, with the superior cerebellar artery (SCA) loop embedded in the nerve at its root entry zone. The arterial loop was mobilized into a new position superior to the nerve, thus liberating it from the impingement. The tentorium was incised, and a fenestrated aneurysm clip was positioned such that the SCA loop was transmitted via the fenestration. The clip was applied across the tentorium, thus suspending the artery in a kink-free orientation that made no contact with the nerve. Conclusion This procedure provided excellent neurovascular decompression without placing mechanical strain on the nerve, relieving the patient's persistent postirradiation TN. The technique could have broader applications for other challenging or atypical microvascular decompression procedures. [ABSTRACT FROM AUTHOR]

BACKGROUND: Most cervical spondylotic myelopathy with cervical curvature straight or cervical kyphosis are spinal cord line type III cervical spondylotic myelopathy. Previous studies have reported that cervical expansive open-door laminoplasty could get satisfied decompression effect of cervical spondylotic myelopathy with curvature straight or cervical kyphosis, while there is no report about the spinal cord line type III cervical spondylotic myelopathy decompression effect of cervical microendoscopic laminoplasty OBJECTIVE: To analyze the decompression effect and charactericstics of cervical microendoscopic laminoplasty on spinal cord line type III cervical spondylotic myelopathy. METHODS: Totally 40 spinal cord line type III cervical spondylotic myelopathy patients (13 males, 27 females, average age of 51.6 years, average disease duration of 16.2 months, average follow-up time of 18.3 months, 55 spinal cord line type III cervical herniated discs) who underwent cervical microendoscopic laminoplasty in the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2021 were retrospectively analyzed. PACS software was utilized to measure the pre-operative and last follow-up cervical magnetic resonance imaging index of the patients. The pre-operative and last follow-up herniated discs volume, cervical Cobb angle and the improved anterior spinal cord compression degree score were compared. RESULTS AND CONCLUSION: (1) All the spinal cord line type III cervical spondylotic myelopathy obtained satisfied decompression effect. The pre-operative improved anterior spinal cord compression degree score was lower than that at last follow-up (P < 0.05). The pre-operative herniated discs volume was smaller than that at the last follow-up (P < 0.05). The cervical Cobb angle increased and cervical curvature was significantly improved (P < 0.05). (2) The results suggested that cervical microendoscopic laminoplasty which had both direct and indirect decompression effect could induce cervical herniated discs to get extensive resorption of herniated nucleus pulposus phenomenon and increase cervical lordosis. The cervical microendoscopic laminoplasty can avoid or reduce anterior discectomy in spinal cord line type III cervical spondylotic myelopathy patients and provide new strategy and basis for clinical treatment of spinal cord line type III cervical spondylotic myelopathy. [ABSTRACT FROM AUTHOR]

(1) Background: Cerebrospinal fluid (CSF) leakage is one of the most common complications of microvascular decompression (MVD) surgery. Before fatal complications, such as intracranial infection, occur, early recognition and prompt treatment are essential. (2) Methods: The clinical data of 475 patients who underwent MVD surgery from September 2020 to March 2023 were retrospectively analyzed. In these patients, if there were any symptoms of CSF leakage, and if CSF leakage was evident, a lumbar drainage catheter was inserted immediately. (3) Results: CSF leakage was suspected in 18 (3.8%) patients. Five of these patients (1.1%) showed signs of CSF leakage during conservative management and subsequently underwent catheter insertion for lumbar drainage. The lumbar drain was removed after an average of 5.2 days, resulting in an average hospitalization of 14.8 days. In all 5 patients, CSF leakage was resolved without reoperation. (4) Conclusions: Our treatment strategy prevented the development of fatal complications. Close observation of the symptoms and postoperative temporal bone computed tomography and audiometry are considered to be good evaluation methods for all patients. If CSF leakage is certain, it is important to perform lumbar drainage immediately. [ABSTRACT FROM AUTHOR]

Objective Capturing and detecting the lost H2 component in the emitted flash gas during conventional decompression sampling towards pressurized sulfur-containing gas field water can realize the more accurate determination of its H2 content, and provide data support for optimizing and upgrading the design and purification efficiency of H2 treatment unit over flash gas. Methods Considering the problem that the determination result of H2 for gas field water after the decompression and balance treatment are obviously low, this work conducts the research from the aspects of pressurized liquid sampling and H2 gas analysis to discuss the influences of parameters including sampling device, sampling method, analysis method, sample pretreatment, acid consumption and stripping time. Results Isobaric sampling is realized, stripping time is 5 min, no pre-filtration treatment is required, deionized water is chosen as the desorption liquid, and the classical iodometry is used as the detection method for hydrogen sulfide. Conclusions By comparing the determination results of H2 content upon actual samples under pressure and decompression conditions, it shows that this technology is more reliable for accurate determination of hydrogen sulfide content in pressurized sulfur-containing gas field water, and will also provide a promising strategy for determination of dissolved gas in other pressurized solutions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to clarify the difference in onset timing and incidence of undiagnosed finger symptom (UDFS) between various shoulder surgical procedures. In this study, UDFS symptoms included the following four symptoms in the fingers; edema, limited range-of-motion, skin color changes, and abnormal sensations. UDFS cases were defined as those presenting with at least one UDFS. In result, the incidence rate of UDFS cases was 7.1% overall (58 / 816 shoulders), 7.4% (32 / 432) in arthroscopic rotator cuff repair (ARCR), 9.0% (11 / 122) in open rotator cuff repair (ORCR), 1.4% (2 / 145) in arthroscopic subacromial decompression (ASD), 13.2% (5 / 38) in open reduction and internal fixation (ORIF), 11.1% (3 / 27) in humeral head replacement, 4.8% (1 / 21) in anatomical total shoulder arthroplasty, and 12.9% (4 / 31) in reverse total shoulder arthroplasty cases. The Rate was significantly higher with ARCR compared to ASD (p < .01). About onset timing in weeks postoperatively, the ORIF group had a statistically earlier symptom onset than the Rotator cuff repair (ARCR + ORCR) group (2.4 weeks vs. 6.0 weeks, p < .01). When classifying the onset timing into before and after the removal of the abduction pillow, the ORIF group showed a statistically higher rate of onset before brace removal than the Rotator cuff repair groups (p < .01). Differences in UDFS among shoulder surgeries were demonstrated in this study. [ABSTRACT FROM AUTHOR]

The article provides information on the ongoing impact of COVID-19 on the orthopedic community, including nursing staffing shortages and changes in procedures and research. It also presents updates on spine surgery, covering topics such as lumbar spine surgical management, technical articles, case series, randomized controlled trials, and the effectiveness of surgical interventions for lumbar disc herniation and degenerative spondylolisthesis.

Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head. [ABSTRACT FROM AUTHOR]

The regulation of erythropoiesis via hemodynamic stimuli such as reduced central blood volume (CBV) remains uncertain in women and elderly individuals. This study assessed the acute effects of lower body negative pressure (LBNP) on key endocrine biomarkers regulating erythropoiesis, that is, erythropoietin (EPO) and copeptin, in young and older women and men (n = 87). Transthoracic echocardiography and hemodynamics were assessed throughout incremental LBNP levels for 1 hour, or until presyncope, with established methods. Venous blood samples were collected at baseline and immediately after termination of the orthostatic tolerance (OT) test for subsequent hormone analyses. The average age of young women and men (33.1 ± 6.0 vs. 29.5 ± 6.9 yr) and older women and men (63.8 ± 8.0 vs. 65.3 ± 8.9 yr) as well as their physical activity levels were matched within each age and sex group. CBV, as determined by right atrial volume, was reduced in all individuals at the end of the OT test (p < 0.001). The average OT time ranged from 50.1 to 58.1 min in all individuals. LBNP increased circulating EPO in young women (p = 0.023) but not in young men or older individuals. Copeptin was increased in all individuals with LBNP but was exclusively associated with EPO in men (r = 0.39, p = 0.013). The present study indicates that the acute hemodynamic regulation of EPO production is both sex‐ and age‐dependent. [ABSTRACT FROM AUTHOR]