BACKGROUND
Short- and mid-term studies have shown the effectiveness of cervical disc arthroplasty (CDA) to treat cervical disc degeneration.
OBJECTIVE
To report the 10-yr outcomes of a multicenter experience with cervical arthroplasty for 1- and 2-level pathology.
METHODS
This was a prospective study of patients treated with CDA at 1 or 2 contiguous levels using the Mobi-C® Cervical Disc (Zimmer Biomet). Following completion of the 7-yr Food and Drug Administration postapproval study, follow-up continued to 10 yr for consenting patients at 9 high-enrolling centers. Clinical and radiographic endpoints were collected out to 10 yr.
RESULTS
At 10 yr, patients continued to have significant improvement over baseline Neck Disability Index (NDI), neck and arm pain, neurologic function, and segmental range of motion (ROM). NDI and pain outcomes at 10 yr were significantly improved from 7 yr. Segmental and global ROM and sagittal alignment also were maintained from 7 to 10 yr. Clinically relevant adjacent segment pathology was not significantly different between 7 and 10 yr. The incidence of motion restricting heterotopic ossification at 10 yr was not significantly different from 7 yr for 1-level (30.7% vs 29.6%) or 2-level (41.7% vs 39.2%) patients. Only 2 subsequent surgeries were reported after 7 yr.
CONCLUSION
Our results through 10 yr were comparable to 7-yr outcomes, demonstrating that CDA with Mobi-C continues to be a safe and effective surgical treatment for patients with 1- or 2-level cervical degenerative disc disease.
This paper presents an overview of the Built-In Soft Error Resilience (BISER) technique for correcting soft errors in latches, flip-flops and combinational logic. The BISER technique enables more than an order of magnitude reduction in chip-level soft error rate with minimal area impact, 7-11% chip-level power impact, and 1-5% performance impact (depending on whether combinational logic error correction is implemented or not). In comparison, several classical error-detection techniques introduce 40-100% power, performance and area overheads, and require significant efforts in designing and validating corresponding recovery mechanisms. Design trade-offs associated with the BISER technique and other existing soft error protection techniques are also analyzed. 1 Who Cares about Soft Errors? only a major concern for space applications. That scenario has changed. Terrestrial radiation has been a growing concern, and many designs today implement extensive error SRAMs. However, memory protection alone is not enough for designs in sub-65nm technologies. Most future designs targeting enterprise computing and communication to be 10 FIT, where 1 FIT corresponds to one error per billion device hours. According to recent Errors Workshop, www.selse.org), a typical value for latch soft error rate may be assumed of design hierarchy and manufacturing process. The soft error rate of a design is generally quantified in terms of Failure-in-time, or Soft errors are radiation-induced transient errors caused by neutrons generated from detection and correction by way of Error Correcting Codes (ECC) mainly for on-chip-3 cosmic rays and alpha particles from packaging material. Traditionally, soft errors were FIT. Note that, there is a lot of variance in latch soft error rates depending on SRAMs. While combinational logic protection may not be an immediate necessity, it may Please use the following format when citing this chapter: There are multiple ways to minimize system-level soft error rate, applied at various levels eventually be required as more and more transistors are integrated in future technologies.
Background: Rigid interspinous process fixation (ISPF) has received consideration as an efficient, minimally disruptive technique in supporting lumbar interbody fusion. However, despite advantageous intraoperative utility, limited evidence exists characterizing midterm to long-term clinical outcomes with ISPF.
Oxiplex/SP Gel was easy to use and safe for patients undergoing unilateral discectomy. Greater benefit in clinical outcome measures was seen in gel-treated patients, especially those with severe leg pain and weakness at baseline.
Mature thoracic intraspinal teratomas are rare tumors in adults. In this case study, we present a case of intradural, extramedullary teratoma, which was surgically resected. A 50 year old man presented with progressive bilateral leg pain, severe myelopathy and weakness. Magnetic Resonance Imaging (MRI) revealed a cystic mass lesion in the T11-12 region region. Microsurgical resection of the tumor using CO2 laser with neuromonitoring was performed. Postoperatively, the patient had a remarkable clinical improvement. Mature spinal teratomas are rare, slow growing spinal tumors. Surgical resection provides excellent recovery, and recurrence rates are low.
We conducted decision analytical modeling using a Markov model to determine the ICER of i-factor compared to autograft in ACDF surgery. Objective: The efficacy and safety of traditional anterior cervical discectomy and fusion (ACDF) surgery has improved with the introduction of new implants and compounds. Costeffectiveness of these innovations remains an often-overlooked aspect of this effort. To evaluate the cost-effectiveness of i-FACTOR compared to autograft for patients undergoing ACDF surgery. Methods: The patient cohort was extracted from a prospective, multicenter randomized control trial (RCT) from twenty-two North American centers. Patients randomly received either autograft (N = 154) or i-Factor (N = 165). We analyzed various real-world scenarios, including inpatient and outpatient surgical settings as well as private versus public insurances. Two primary outcome measures were assessed: cost and utility. In the base-case analysis, both health and societal system costs were evaluated. Health-related utility outcome was expressed in quality-adjusted life years (QALYs). Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER). Results: In all scenarios, i-FACTOR reduced costs within the first year by 1.4% to 2.1%. The savings proved to be incremental over time, increasing to 3.7% over an extrapolated 10 years. The ICER at 90 days was $13,333 per QALY and became negative ("dominated") relative to the control group within one year and onwards. In a threshold sensitivity analysis, the cost of i-FACTOR could theoretically be increased 70-fold and still remain cost-effective.
Conclusion:The novel i-FACTOR is not only cost-effective compared to autograft in ACDF surgery but is the dominant economic strategy.
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