Percutaneous osteoplasty for extraspinal metastases

As an extension of percutaneous vertebroplasty(PVP), percutaneous osteoplasty(POP) refers broadly to percutaneous bone cement injected into various parts of the body and narrowly to cement injected into extraspinal bone lesions. POP mainly includes such surgeries as percutaneous sacroplasty, percutaneous acetabuloplasty, percutaneous femoral osteoplasty, and percutaneous iliac osteoplasty(Figure 1). Currently, POP is a positive and an effective treatment for extraspinal bone lesions in that it can rapidly relieve pain, effectively prevent pathological fractures, and partially inactivate tumors, with few complications. The aim of this review is to detail the POP techniques and report their safety and efficacy in the treatment of extraspinal metastases.

Comparison of the postoperative pain change and spinal stenosis rate between percutaneous vertebroplasty combined with radiofrequency ablation and with ^(125)I particle implantation in the treatment of metastatic spinal cord compression:A retrospective st

Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.

Evaluate the characteristics and clinical significance of “toxic twin-leaf” sign in spinal epidural metastases before percutaneous vertebroplasty

Objective: Our study aimed to analyze morphological features of spinal epidural metastases using magnetic resonance imaging(MRI) and investigate the formation mechanism and clinical significance of the "toxic twinleaf" sign in spinal epidural metastasis.Materials and methods: We retrospectively studied 108 patients with spinal epidural metastases who underwent MRI. Patients were divided into "toxic twin-leaf" sign group(group A) and irregular group(group B). Chi-square test was used to analyze data on sex, vertebra location, presence of fracture in the corresponding vertebral body,involvement of the corresponding pedicle, and the primary tumor. Further, group data were analyzed using the rank sum test;p < 0.05 was considered significant.Results: The "twin-leaf" sign was noted in 88 cases with 136 epidural masses and 20 cases of irregular shape in 108 patients;the "toxic twin-leaf" sign accounted for 87.18% of spinal epidural metastases. A difference between groups in the vertebra location(p < 0.01) was observed, but no differences were found in sex, presence of fractures in the corresponding vertebral body, involvement of the corresponding pedicle, and primary tumor(p >0.05). Intergroup differences in the rate of spinal stenosis on axial and sagittal images were significant.Conclusions: MRI axial sequences clearly revealed the morphology of spinal epidural metastases. Detection of the"toxic twin-leaf" sign in spinal epidural metastases was of great clinical significance. Furthermore, determining the degree of spinal stenosis in the axial sequence provided a more accurate evaluation of patients’ condition compared to the sagittal sequence.

Silk fibroins modify the atmospheric low temperature plasma-treated poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) film for the application of cardiovascular tissue engineering

Tissue engineered scaffold is one of the hopeful therapies for the patients with organ or tissue damages. The key element for a tissue engineered scaffold material is high biocompatibility. Herein the poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) film was irradiated by the low temperature atmospheric plasma and then coated by the silk fibroins (SF). After plasma treatment, the surface of PHBHHx film became rougher and more hydrophilic than that of original film. The experiment of PHBHHx flushed by phosphate buffer solution (PBS) proves that the coated SF shows stronger immobilization on the plasma-treated film than that on the untreated film. The cell viability assay demonstrates that SF-coated PHBHHx films treated by the plasma significantly supports the proliferation and growth of the human smooth muscle cells (HSMCs). Furthermore, the scanning electron microscopy and hemotoylin and eosin (HE) staining show that HSMCs formed a cell sub-monolayer and secreted a large amount of extracellular matrix (ECM) on the films after one week's culture. The silk fibroins modify the plasma-treated PHBHHx film, providing a material potentially applicable in the cardiovascular tissue engi-neering.