Background:Pedicle screw technique is commonly used treatment of adult spinal trauma, tumor, degeneration. The application of pedicle screws is very challenging in children because children have a fast growing spine and spinal pedicle morphology of children and adult has large difference. 3 D reconstruction individual navigation templates improve the success rate of pediatric pedicle screw system. This study is aimed to provide a precise method for lumbar spine pedicle screw placement in children using computer-aided design and rapid prototyping technology.Materials and Methods:Computed tomography (CT) scans of cadaver specimens of 4 children were obtained, and the raw data were reconstructed using three-dimensional reconstruction software. Pedicle screws were placed using the conventional method or by using individually designed navigation templates based on the principles of reverse engineering and rapid prototyping technology.Results:We evaluated the accuracy of the pedicle screws placed using the two methods by CT scan. Ten navigation templates were designed for placement of 20 lumbar pedicle screws in the navigation group, and CT scan confirmed that all the screws were placed accurately in the corresponding pedicle. Conversely, of the 20 lumbar pedicle screws placed using the conventional method, 3 screws perforated the pedicle. The findings showed that lumbar pedicle screw placement was successful using navigation templates in children.Conclusions:This technique is simple, easy to master, and allows personalized screw placement, thus providing a new and feasible method for lumbar pedicle screw placement in children.
IntroductionSpinal pedicle screw internal fixation has been widely used in adult spine injury fixation. Due to being in a period of continuous growth and development, the spine of children at different ages shows different characteristics from adults in terms of anatomy, physiological function, and biomechanics. Furthermore, because the pedicle of children is small, has large anatomic variation, and has complex adjacent relationships, the surgical risk is extremely high. How to improve the screwing accuracy is the key to the success of children’s pedicle internal fixation. Therefore, applying the concept of digitized and individualized screwing will be of great significance to children’s pedicle screwing.AimTo investigate the morphologies, development patterns, and aging characteristics of the lumbar vertebral pedicle (LVP) in children aged 6–11 years, and to provide a theoretical basis for screw implantation and related biomechanical studies.Material and methodsA total of 60 children aged 6–11 years were selected for the intergroup measurement and statistical analysis of their lumbar diameter, pedicle diameter, screw canal length (SCL), etc.ResultsGenerally, the vertebral foramen diameter (ID), sagittal diameter (SD), pedicle width (PW), and SCL as well as the pedicle height (PH) exhibited an increasing trend with age and increasing vertebral sequence among children aged 6–11 years.ConclusionsBy observing the LVP in children using 3D digital reconstruction technology, the morphology of the spinal canal and pedicles at different lumbar segments showed obvious development patterns, and the best treatment protocol should be selected according to the LVP characteristics in clinical applications.
In this study, micro-CT was used to observe the microscopic anatomy of the hyoid bone, examine the variation of the trabecular bone inside the hyoid bone, and investigate the internal structure of the hyoid bone. A total of 22 hyoid bones were scanned using micro-CT. The changes in the internal bone trabeculae were assessed with 3D reconstructions, and the fine anatomical structure of the hyoid bone was further analyzed. Micro-CT images showed the microstructure of various parts of the hyoid bone. There were significant differences in total volume, bone volume, bone area, bone density, and volume fraction between the body and greater horns of the hyoid bone ( P < .05), but no significant differences in the ratio of bone area/volume and bone surface density were found between the body and greater horns of the hyoid bone ( P > .05). In addition, significant differences in the trabecular bone measurements, bone trabecular connectivity, and Euler number were found between the body and greater horns of the hyoid bone ( P < .05). Other parameters, including bone trabecular thickness, number of trabecular bones, bone trabecular structure model index, and anisotropy of bone trabeculae, did not differ between the body and greater horns of the hyoid bone ( P > .05). There was noticeably ossified healing at the joint between the body and greater horns of the hyoid bone. Micro-CT can adequately display the internal structure of the hyoid bone. The identified bone structure may help clarify the physiological function of the hyoid bone. The present findings provide a theoretical basis for further studies aimed at pathological changes due to hyoid injury in clinical and forensic medicine.
Objective. At present, glucocorticoids combined with cyclophosphamide are still used for the clinical treatment of systemic lupus erythematosus (SLE). However, long-term practice has shown that drug treatment currently has the phenomena of long treatment duration, uncontrollable conditions in a short period of time, and unsatisfactory efficacy. DNA immunoadsorption therapy is a newly developed therapy. The combination of drugs and DNA immunoadsorption has been reported for the treatment of SLEN in clinics for a long time. In this study, we observed the effects of DNA immunoadsorption combined with drug therapy on immune function and renal function in patients with systemic lupus erythematosus (SLE). The results showed that the DNA immunosorbent assay combined with medication in the treatment of SLE could quickly and specifically remove pathogenic substances from patients, improve renal function, immune function, and complement levels in patients, and help to relieve disease activity.
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