METHODS: Thirty individuals (age, 64-88 years) with progressive deformity (coronal Cobb angles > 25 degrees and < 85 degrees), intractable back pain, radiculopathy, or neurogenic claudication were treated by less invasive decompression and fusion (unilateral transforaminal interbody
cage instrumentation and bilateral facet fusions) with recombinant human bone morphogenetic protein-2, spanning 3 to 8 segments (average, 6 segments), using biplanar fluoroscopy or intraoperative computed tomography (iCT)-based navigation. Accuracy of screw placement, curve correction, and fusion rate were evaluated during a mean follow-up of 19.6 months.
RESULTS: With 415 screws implanted, misplacement (grade II or greater) was not observed, and no implants required revision. Spinal iCT with automated registration JNK-IN-8 required 17.5 +/- 8.5 minutes (single registration PI3K inhibitor for all segments); monosegmental bilateral screw insertion required 6.8 +/- 3.4 minutes. Mean sagittal (coronal) Cobb angle correction was 44.8 +/- 10.7 degrees (31.7 +/- 13.7 degrees).
Mean lumbar lordosis increased from 8.8 +/- 8.9 degrees to -36 +/- 6.9 degrees, and sagittal balance was reduced from 31.6 +/- 15.2 to 8 +/- 8.4 mm. Solid fusion was confirmed in 90% of instrumented segments at 16 months. Average radiation dose to the surgeon was 0.025 mSv for single-level transforaminal lumbar interbody fusion with fluoroscopic guidance vs 0 mSv with iCT navigation.
CONCLUSION: Instrumented Idoxuridine correction of adult deformity was significantly facilitated by iCT navigation, eliminating radiation exposure
to the surgeon. Intraoperative biplanar CT scout views including pelvis and shoulders allow comprehensive assessment of multiplanar deformity correction. Fusion rates obtained with less invasive access equal those of conventional open technique.”
“Existing equations to calculate the estimated glomerular filtration rate (eGFR) were derived from nondiabetic Caucasian patients with chronic kidney disease. Here, we developed formulas to more accurately predict the eGFR in Chinese patients with type 2 diabetes and validated their performance in 202 type 2 diabetic and 46 nondiabetic individuals. Within the diabetic cohort, 135 were randomly assigned to a training group, whereas the remaining 67 diabetic and all of the nondiabetic patients were assigned to a validation group. Reference GFR was measured by (51)Cr-EDTA plasma clearance. The new eGFR-estimating formulas, derived using a stepwise regression model, were compared with existing prediction equations in the validation group. The formulas are: 313 x (Age) – 0.494 (years) x [SCr] – 1.059 (mg/dl) x [Alb] + 0.485 (g/dl) for men, and 783 x (Age) – 0.489 (years) x [SCr] – 0.877 (mg/dl) x [SUN] – 0.150 (mg/dl) for women.