Background:
Lumbar decompressive surgery is a standard surgical technique for lumbar spinal stenosis. Many new surgical techniques have been introduced, ranging from open surgery to minimally invasive procedures. Minimally invasive surgical techniques are preferred because patients experience less postoperative pain and shorter hospital stays. However, the success rate of minimally invasive techniques have been controversial. The object of this study was to assess the feasibility of spinal decompression using biportal technique/endoscopic surgery compared with microscopic surgery.
Methods:
Seventy lumbar spinal stenosis patients undergoing laminectomy were included in this study. A number table was used to randomize the patients into two groups: a biportal technique/endoscopic surgery group (BG-36) and a microscopic surgery group (OG-34). One surgeon performed either biportal technique/endoscopic decompression or microscopic decompression using a tubular retractor, depending on the group to which the patient was randomized. Perioperative data and clinical outcomes at postoperative 6 months were collected and analyzed.
Results:
The demographic data and level of surgery were comparable between the two groups. A shorter operation time (36 ± 11 vs 54 ± 9 min), less hemovac drain output (25.5 ± 15.8 vs 53.2 ± 32.1 ml), less opioid usage (2.3 ± 0.6 vs 6.5 ± 2.5 T) and shorter hospital stay (1.2 ± 0.3 vs 3.5 ± 0.8 days) were shown in BG. The BG experienced no significant differences in clinical outcomes compared with OG. Favorable clinical outcomes were shown at 6 months after surgery in both groups.
Conclusion:
Lumbar decompressive surgery using biportal technique/endoscopy showed favorable clinical outcomes, less pain and a shorter hospital stay compared to microscopic surgery in patients with lumbar spinal stenosis.
This paper describes a method to generate a concentration gradient using an osmosis-driven pump, without the need for bulky peripheral devices, such as an electric syringe pump or a pneumatic pump. By the osmosis, the flow in the microfluidic channel can be controlled even to a very slow speed (nanolitre scale), which enables its application to generate the stable and wide (width = 4 mm) concentration gradient profile, even within a short flow path. A computational simulation was also performed to predict the local distribution of the solute concentration and velocity-pressure profile in the microfluidic chip. The performance of the osmosis-driven pump was evaluated by culturing human mesenchymal stem cells within the concentration gradient of fetal bovine serum. The effects of the gradient on attachment, viability and morphology of the cells were analyzed and quantified. The cell density in a higher serum concentration region was twice greater than that in the pure culture media. The compact, cost-effective, self-powered and osmosis-based gradient generation system can be useful for biomedical and chemical applications.
Conclusion:This study demonstrates the feasibility of TES for the molecular diagnosis of skeletal dysplasia. However, further confirmation is needed for a final molecular diagnosis, including Sanger sequencing of candidate variants with suspected, poorly captured exons.
We found that sonographically guided tendon sheath injections were more accurate and may be potentially safer than blind injections. These findings suggest that sonographically guided injections should be considered over blind injections when treating trigger finger.
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