Negative pressure wound therapy in spinal fusion patients.
fusion; spine; outcomes; negative pressure wound therapy; surgical site infection
Post-operative wound complications are some of the most common acute complications following spine surgery. These surgical site infections (SSI) contribute to increased healthcare related costs. Negative pressure wound therapy (NPWT) has long been used for treatment of soft tissue injury or defects. NPWT may reduce the incident of SSI following spinal fusion procedures; however, its potential applications need further clarification. Thus, we conducted a retrospective analysis of two cohorts to compare NPWT to traditional sterile dressings following spinal fusions in regards to post-operative outcomes. Following institutional review board approval, 42 patients who had a NPWT were matched by type of surgery to 42 patients who had traditional dressings. A retrospective chart-review was completed. Outcome measures, particularly SSI and need for reoperation, were analyzed using one-way ANOVA for both univariate and multivariate analysis. When controlled for sex and body-mass index, the use of a NPWT was independently correlated with decreased SSI (P = .035). Superficial dehiscence, seroma, need for additional outpatient care, and need for operative revision were all found to occur at higher rates in the traditional dressing cohort. Closed incisional negative pressure wound therapy provides a cost-effective method of decreasing surgical site infection for posterior elective spine surgeries.
Akhter AS; McGahan BG; Close L; Dornbos D; Toop N; Thomas NR; Christ E; Dahdaleh NS; Grossbach AJ
International Wound Journal
2020
2020-11-25
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1111/iwj.13507" target="_blank" rel="noreferrer noopener">10.1111/iwj.13507</a>
Mandibular symphyseal fusion in fossil primates: Insights from correlated patterns of jaw shape and masticatory function in living primates.
fusion; mandible; PRIMATES; geometric morphometrics; symphysis; ELECTROMYOGRAPHY; LEMURS; MANDIBLE; MORPHOMETRICS
Objectives: Variation in primate masticatory form and function has been extensively researched through both morphological and experimental studies. As a result, symphyseal fusion in different primate clades has been linked to either the recruitment of vertically directed balancing‐side muscle force, the timing and recruitment of transversely directed forces, or both. This study investigates the relationship between jaw muscle activity patterns and morphology in extant primates to make inferences about masticatory function in extinct primates, with implications for understanding the evolution of symphyseal fusion. Materials and methods: Three‐dimensional mandibular landmark data were collected for 31 extant primates and nine fossil anthropoids and subfossil lemur species. Published electromyography (EMG) data were available for nine of the extant primate species. Partial least squares analysis and phylogenetic partial least squares analysis were used to identify relationships between EMG and jaw shape data and evaluate variation in jaw morphology. Results: Primates with partial and complete symphyseal fusion exhibit shape‐function patterns associated with the wishboning motor pattern and loading regime, in contrast to shape‐function patterns of primates with unfused jaws. All fossil primates examined (except Apidium) exhibit jaw morphologies suggestive of the wishboning motor pattern demonstrated in living anthropoids and indriids. Discussion Partial fusion in Catopithecus, similar to indriids and some subfossil lemurs, may be sufficient to resist, or transfer, some amounts of transversely directed balancing‐side muscle force at the symphysis, representing a transition to greater reliance on transverse jaw movement during mastication. Furthermore, possible functional convergences in physiological patterns during chewing (i.e., Archaeolemur) are identified. [ABSTRACT FROM AUTHOR]
Knigge RP;Vinyard CJ;McNulty KP
American Journal Of Physical Anthropology
2020
2020-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1002/ajpa.24048" target="_blank" rel="noreferrer noopener">10.1002/ajpa.24048</a>
Ternporalis Function In Anthropoids And Strepsirrhines: An Emg Study
adductor muscle force; Anthropology; biomechanics; electromyography; Evolutionary Biology; fusion; galago crassicaudatus; invivo bone strain; jaw-adductor muscle force; macaca-fascicularis; mandibular symphysis; masseter force; mastication; patterns; postorbital septum; primates; temporalis
The major purpose of this study is to analyze anterior and posterior temporalis muscle force recruitment and firing patterns in various anthropoid and strepsirrhine primates. There are two specific goals for this project. First, we test the hypothesis that in addition to transversely directed muscle force, the evolution of symphyseal fusion in primates may also be linked to vertically directed balancing-side muscle force during chewing (Hylander et al. [2000] Am. J. Phys. Anthropol. 112:469-492). Second, we test the hypothesis of whether strepsirrhines retain the hypothesized primitive mammalian condition for the firing of the anterior temporalis, whereas anthropoids have the derived condition (Weijs [1994] Biomechanics of Feeding in Vertebrates; Berlin: Springer-Verlag, p. 282-320). Electromyographic (EMG) activities of the left and right anterior and posterior temporalis muscles were recorded and analyzed in baboons, macaques, owl monkeys, thick-tailed galagos, and ring-tailed lemurs. In addition, as we used the working-side superficial masseter as a reference muscle, we also recorded and analyzed EMG activity of the left and right superficial masseter in these primates. The data for the anterior temporalis provided no support for the hypothesis that symphyseal fusion in primates is linked to vertically directed jaw muscle forces during mastication. Thus, symphyseal fusion in primates is most likely mainly linked to the timing and recruitment of transversely directed forces from the balancing-side deep masseter (Hylander et al. [2000] Am. J. Phys. Anthropol. 112:469-492). In addition, our data demonstrate that the firing patterns for the working- and balancing-side anterior temporalis muscles are near identical in both strepsirrhines and anthropoids. Their working- and balancing-side anterior temporalis muscles fire asynchronously and reach peak activity during the power stroke. Similarly, their working- and balancing-side posterior temporalis muscles also fire asynchronously and reach peak activity during the power stroke. Compared to these strepsirrhines, however, the balancing-side posterior temporalis of anthropoids appears to have a relatively delayed firing pattern. Moreover, based on their smaller W/B ratios, anthropoids demonstrate a relative increase in muscle-force recruitment of the balancing-side posterior temporalis. This in turn suggests that anthropoids may emphasize the duration and magnitude of the power stroke during mastication. This hypothesis, however, requires additional testing. Furthermore, during the latter portion of the power stroke, the late activity of the balancing-side posterior temporalis of anthropoids apparently assists the balancing-side deep masseter in driving the working-side molars through the terminal portion of occlusion.
Hylander W L; Wall C E; Vinyard C J; Ross C; Ravosa M R; Williams S H; Johnson K R
American Journal of Physical Anthropology
2005
2005-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1002/ajpa.20058" target="_blank" rel="noreferrer noopener">10.1002/ajpa.20058</a>
Functional And Evolutionary Significance Of The Recruitment And Firing Patterns Of The Jaw Adductors During Chewing In Verreaux's Sifaka (propithecus Verreauxi)
Anthropology; biomechanics; bone-strain; electromyography; Evolutionary Biology; Force; fusion; lemurs lemur-catta; macaca-fascicularis; mandibular symphysis; masseter force; mastication; muscle; primates; strepsirrhines; wishboning
Jaw-muscle electromyographic (EMG) patterns indicate that compared with thick-tailed galagos and ring-tailed lemurs, anthropoids recruit more relative EMG from their balancing-side deep masseter, and that this muscle peaks late in the power stroke. These recruitment and firing patterns in anthropoids are thought to cause the mandibular symphysis to wishbone (lateral transverse bending), resulting in relatively high symphyseal stresses. We test the hypothesis that living strepsirrhines with robust, partially fused symphyses have muscle recruitment and firing patterns more similar to anthropoids, unlike those strepsirrhines with highly mobile unfused symphyses. Electromyographic (EMG) activity of the superficial and deep masseter, anterior and posterior temporalis, and medial pterygoid muscles were recorded in four dentally adult Verreaux's sifakas (Propithecus verreauxi). As predicted, we find that sifaka motor patterns are more similar to anthropoids. For example, among sifakas, recruitment levels of the balancing-side (b-s) deep masseter are high, and the b-s deep masseter fires late during the power stroke. As adult sifakas often exhibit nearly complete symphyseal fusion, these data support the hypothesis that the evolution of symphyseal fusion in primates is functionally linked to wishboning. Furthermore, these data provide compelling evidence for the convergent evolution of the wishboning motor patterns in anthropoids and sifakas. Am J Phys Anthropol 145:531-547, 2011. (C) 2011 Wiley-Liss, Inc.
Hylander W L; Vinyard C J; Wall C E; Williams S H; Johnsonl K R
American Journal of Physical Anthropology
2011
2011-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1002/ajpa.21529" target="_blank" rel="noreferrer noopener">10.1002/ajpa.21529</a>
Intervertebral and Epiphyseal Fusion in the Postnatal Ontogeny of Cetaceans and Terrestrial Mammals
baleen; Cetacea; Evolutionary Biology; Zoology; India; skeleton; morphology; artiodactyls; Eocene; whales; locomotor evolution; body length; Epiphyseal; fusion; Intervertebral; Vertebra; vertebral osteology
In this paper we studied three related aspects of the ontogeny of the vertebral centrum of cetaceans and terrestrial mammals in an evolutionary context. We determined patterns of ontogenetic fusion of the vertebral epiphyses in bowhead whale (Balaena mysticetus) and beluga whale (Delphinapterus leucas), comparing those to terrestrial mammals and Eocene cetaceans. We found that epiphyseal fusion is initiated in the neck and the sacral region of terrestrial mammals, while in recent aquatic mammals epiphyseal fusion is initiated in the neck and caudal regions, suggesting locomotor pattern and environment affect fusion pattern. We also studied bony fusion of the sacrum and evaluated criteria used to homologize cetacean vertebrae with the fused sacrum of terrestrial mammals. We found that the initial ossification of the vertebral pedicles in the fetus may be a reliable indicator of sacral homology inmodern cetaceans. Finally, we also studied fusion of the centra of cervical vertebrae in B. mysticetus and found that it is not completed until after sexual maturity, and after 20 years of age.
Moran M M; Bajpai S; George J C; Suydam R; Usip S; Thewissen J G M
Journal of Mammalian Evolution
2015
2015-03
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s10914-014-9256-7" target="_blank" rel="noreferrer noopener">10.1007/s10914-014-9256-7</a>
The association of sacroiliac joint bridging with other enthesopathies in the human body
Orthopedics; Neurosciences & Neurology; disease; prevalence; fusion; ankylosing-spondylitis; arthritis; spondyloarthropathy; abnormalities; criteria; erosive; idiopathic skeletal hyperostosis; ankylosing-spondylitis; sacroiliac joint; diffuse idiopathic skeletal hyperostosis; dish; ankylosing; entheseal; forestier; reaction; spinal diseases
Study Design. A descriptive study of the association between sacroiliac joint (extra-articular) bridging and other enthesopathies. Objectives. To examine the relationship between sacroiliac joint bridging with other entheseal reaction sites in the skeleton, and its prognostic value in spinal diseases. Summary of Background Data. Sacroiliac joint bridging is considered a hallmark of spinal diseases ( e. g., ankylosing spondylitis). Nevertheless, its association with other enthesopathies has never been quantified and analyzed. Methods. A total of 289 human male skeletons with sacroiliac joint bridging and 127 without ( of similar demographic structure) were evaluated for the presence of entheseal ossification, cartilaginous calcification, and other axial skeleton joint fusion ( a total of 18 anatomic sites). The presence of diffuse idiopathic skeletal hyperostosis and spondyloarthropathy was also recorded. Results. Sacroiliac joint bridging was strongly associated with entheseal reactions in other parts of the body. Of the sacroiliac joint bridging group, 24.91% had diffuse idiopathic skeletal hyperostosis, and 8.05% had spondyloarthropathy. Conclusions. The presence of sacroiliac joint bridging indicates an intensive general entheseal process in the skeleton.
Dar G; Peleg S; Masharawi Y; Steinberg N; Rothschild B M; Hershkovitz I
Spine
2007
2007-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/01.brs.0000261568.88404.18" target="_blank" rel="noreferrer noopener">10.1097/01.brs.0000261568.88404.18</a>
Effect of 1-palmitoyl lysophosphatidylcholine on phase properties of 1,2-dipalmitoyl phosphatidylethanolamine: A thermodynamic and NMR study
Biophysics; Biochemistry & Molecular Biology; cholesterol; fusion; lysolecithin; lipid; membranes; bilayer; H-2-NMR; transition; nuclear-magnetic-resonance; phosphatidylcholine vesicles; lecithin; bilayers; DSC; mixtures; P-31-NMR; phosphatidylethanolamine
The effect of 1-palmitoyl lysophosphatidylcholine (PLPC) on the phase behaviour of 1,2-dipalmitoyl phosphatidylethanolamine (DPPE) in excess water (34 wt%) has been examined by differential scanning calorimetry, scanning dilatometry and isothermal compressibility measurements. Mole percentages of PLPC in DPPE between 14 and 62% have been studied over the temperature range 30-75 degrees C. The temperature dependence of orientational ordering at selected sites in H-2-labelled PLPC and 2H(2)O has been determined from measurement of time-averaged chemical shift anisotropies and quadrupole splittings in the P-31- and H-2-NMR spectra. These data have been used to further characterize phase behaviour. At less than equimolar contents of PLPC, when a single phase transition with a reduced transition temperature is observed, spectral and calorimetric data indicate complete miscibility of the two lipid components. An equimolar mixture of PLPC and DPPE shows a sharp first order transition at 47.3 degrees C and a second order transition at 62.5 degrees C. NMR data are consistent with the existence of a defective bilayer at intermediary temperatures. In this range it is proposed that PLPC molecules prefer regions with high curvature in the vicinity of the defects, while DPPE molecules are mostly confined to flatter regions of the bilayer. A possible molecular model is described, At temperatures above 62.5 degrees C, PLPC and DPPE are completely miscible and exist as lamellae. At higher PLPC content (> 50 mol%), thermodynamic and spectral data are indicative of phase separation of the two components over the temperature range examined.
Checchetti A; Golemme A; Chidichimo G; LaRosa C; Grasso D; Westerman P W
Chemistry and Physics of Lipids
1996
1996-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/0009-3084(96)02574-1" target="_blank" rel="noreferrer noopener">10.1016/0009-3084(96)02574-1</a>
ZYGAPOPHYSEAL AND COSTOVERTEBRAL COSTOTRANSVERSE JOINTS - AN ANATOMIC ASSESSMENT OF ARTHRITIS IMPACT
costovertebral joint; defleshed bones; diffuse idiopathic skeletal hyperostosis; enthesopathy; erosion; erosive arthritis; fusion; involvement; osteoarthritis; pathogenesis; rheumatoid-arthritis; rheumatoid-arthritis; Rheumatology; spine; spondyloarthropathy; zygapophyseal joint
Sanzhang C; Rothschild B M
British Journal of Rheumatology
1993
1993-12
Journal Article
n/a
A Preliminary Analysis of Correlated Evolution in Mammalian Chewing Motor Patterns
alpacas; discrete characters; electromyography; emg; fusion; jaw movements; masseter; masticatory muscles; mechanics; morphology; symphyseal; Zoology
Descriptive and quantitative analyses of electromyograms (EMG) from the jaw adductors during feeding in mammals have demonstrated both similarities and differences among species in chewing motor patterns. These observations have led to a number of hypotheses of the evolution of motor patterns, the most comprehensive of which was proposed by Weijs in 1994. Since then, new data have been collected and additional hypotheses for the evolution of motor patterns have been proposed. Here, we take advantage of these new data and a well-resolved species-level phylogeny for mammals to test for the correlated evolution of specific components of mammalian chewing motor patterns. We focus on the evolution of the coordination of working-side (WS) and balancing-side (BS) jaw adductors (i.e., Weijs' Triplets I and II), the evolution of WS and BS muscle recruitment levels, and the evolution of asynchrony between pairs of muscles. We converted existing chewing EMG data into binary traits to incorporate as much data as possible and facilitate robust phylogenetic analyses. We then tested hypotheses of correlated evolution of these traits across our phylogeny using a maximum likelihood method and the Bayesian Markov Chain Monte Carlo method. Both sets of analyses yielded similar results highlighting the evolutionary changes that have occurred across mammals in chewing motor patterns. We find support for the correlated evolution of (1) Triplets I and II, (2) BS deep masseter asynchrony and Triplets I and II, (3) a relative delay in the activity of the BS deep masseter and a decrease in the ratio of WS to BS muscle recruitment levels, and (4) a relative delay in the activity of the BS deep masseter and a delay in the activity of the BS posterior temporalis. In contrast, changes in relative WS and BS activity levels across mammals are not correlated with Triplets I and II. Results from this work can be integrated with dietary and morphological data to better understand how feeding and the masticatory apparatus have evolved across mammals in the context of new masticatory demands.
Williams S H; Vinyard C J; Wall C E; Doherty A H; Crompton A W; Hylander W L
Integrative and Comparative Biology
2011
2011-08
Journal Article
<a href="http://doi.org/10.1093/icb/icr068" target="_blank" rel="noreferrer noopener">10.1093/icb/icr068</a>
Masticatory motor patterns in ungulates: A quantitative assessment of jaw-muscle coordination in goats, alpacas and horses
electromyography; emg; force; fusion; mandibular symphysis; masseter muscle; movements; pigs; Zoology
We investigated patterns of jaw-muscle coordination during rhythmic mastication in three species of ungulates displaying the marked transverse jaw movements typical of many large mammalian herbivores. In order to quantify consistent motor patterns during chewing, electromyograms were recorded from the superficial masseter, deep masseter, posterior temporalis and medial pterygoid muscles of goats, alpacas and horses. Timing differences between muscle pairs were evaluated in the context of an evolutionary model of jaw-muscle function. In this model, the closing and food reduction phases of mastication are primarily controlled by two distinct muscle groups, triplet I (balancing-side superficial masseter and medial pterygoid and working-side posterior temporalis) and triplet II (working-side superficial masseter and medial pterygoid and balancing-side posterior temporalis), and the asynchronous activity of the working- and balancing-side deep masseters. The three species differ in the extent to which the jaw muscles are coordinated as triplet I and triplet II. Alpacas, And to a lesser extent, goats, exhibit the triplet pattern whereas horses do not. In contrast, all three species show marked asynchrony of the working-side and balancing-side deep masseters, with jaw closing initiated by the working-side muscle and the balancing-side muscle firing much later during closing. However, goats differ from alpacas and horses in the timing of the balancing-side deep masseter relative to the triplet II muscles. This study highlights interspecific differences in the coordination of jaw muscles to influence transverse jaw movements and the production of bite force in herbivorous ungulates.
Williams S H; Vinyard C J; Wall C E; Hylander W L
Journal of Experimental Zoology Part a-Ecological Genetics and Physiology
2007
2007-04
Journal Article
<a href="http://doi.org/10.1002/jez.a.362" target="_blank" rel="noreferrer noopener">10.1002/jez.a.362</a>
Spine update - Lumbar interbody cages
anterior; arthrodesis; bone; cages; carbon; composite; fusion; interface; in-vitro; lumbar spine; material orthopedic implants; model; Neurosciences & Neurology; Orthopedics; wear
Interbody cage devices, used to assist interbody fusion, are rapidly gaining popularity in the surgical management of chronic low back pain. This update provides a structural classification of commonly used devices and assesses them against a set of clearly defined surgical goals, including ability to correct the existing mechanical deformation, ability to provide mechanical stability, ability to provide a suitable environment for arthrodesis, and ability to limit "built-in" morbidity. In addition, the materials used in the devices are examined regarding their biomechanical, biologic, and radiographic characteristics.
Weiner B K; Fraser R D
Spine
1998
1998-03
Journal Article
<a href="http://doi.org/10.1097/00007632-199803010-00020" target="_blank" rel="noreferrer noopener">10.1097/00007632-199803010-00020</a>
A thermodynamic and NMR investigation of 1-lyso-palmitoyllecithin/1,2-dipalmitoylphosphatidylethanol-amine/water system
cholesterol; Crystallography; fusion; liposomal membranes; lysolecithin; temperature; vesicle
The effect of incorporation of 1-palmitoyl-sn-glycero-3-phosphocholine (PLPC) on the bilayer structures occurring in aqueous dispersions of 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine (DPPE) has been studied by phosphorus 31 nuclear magnetic resonance and calorimetric methods. The polymorphism of the system as a function of PLPC concentration has been defined. Experimental data allowed us to determine phase boundaries. Changes of molecular packing of the PLPC molecules in DPPE bilayers in the phase diagram are invoked to explain the experimental findings.
Nicoletta F P; Checchetti A; Grasso D; Imbardelli D; LaRosa C; Westerman P; Chidichimo G
Molecular Crystals and Liquid Crystals Science and Technology Section a-Molecular Crystals and Liquid Crystals
1996
1996
Journal Article
<a href="http://doi.org/10.1080/10587259608031892" target="_blank" rel="noreferrer noopener">10.1080/10587259608031892</a>