Cervical Laminoplasty Construct Stability: A Finite Element Study

2008 ◽  
Author(s):  
Srinivas C. Tadepalli ◽  
Nicole A. Kallemeyn ◽  
Kiran H. Shivanna ◽  
Joseph Smucker ◽  
Douglas C. Fredericks ◽  
...  
Keyword(s):  
United States ◽  
Finite Element ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
The United States ◽  
Cervical Laminoplasty ◽  
Finite Element Study ◽  
Multi Level ◽  
Laminectomy And Fusion ◽  
Element Study

Cervical laminoplasty is one of many modern techniques utilized in the management of cervical myelopathy. In the United States cervical spondylotic myelopathy (CSM) has been classically treated with multilevel decompression and fusion. Furthermore, multi-level anterior cervical decompression and fusion (ACDF), via disectomies or corpectomies, and multi-level cervical laminectomy and fusion have been well described [1]. In the last decade cervical laminoplasty has grown in popularity as a non-fusion alternative that allows multi-level cervical decompression.

scholarly journals A Prospective, Randomized Trial Comparing Expansile Cervical Laminoplasty and Cervical Laminectomy and Fusion for Multilevel Cervical Myelopathy

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. 264-277 ◽  
Author(s):  
Glen R. Manzano ◽  
Gizelda Casella ◽  
Michael Y. Wang ◽  
Steven Vanni ◽  
Allan D. Levi
Keyword(s):  
Range Of Motion ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
Cervical Laminoplasty ◽  
Japanese Orthopedic Association Score ◽  
Association Score ◽  
Japanese Orthopedic Association ◽  
Canal Area ◽  
Cervical Laminectomy ◽  
Laminectomy And Fusion

Abstract BACKGROUND: Controversy exists as to the best posterior operative procedure to treat multilevel compressive cervical spondylotic myelopathy. OBJECTIVE: To determine clinical, radiological, and patient satisfaction outcomes between expansile cervical laminoplasty (ECL) and cervical laminectomy and fusion (CLF). METHODS: We performed a prospective, randomized study of ECL vs CLF in patients suffering from cervical spondylotic myelopathy. End points included the Short Form-36, Neck Disability Index, Visual Analog Scale, modified Japanese Orthopedic Association score, Nurick score, and radiographic measures. RESULTS: A survey of academic North American spine surgeons (n = 30) demonstrated that CLF is the most commonly used (70%) posterior procedure to treat multilevel spondylotic cervical myelopathy. A total of 16 patients were randomized: 7 to CLF and 9 to ECL. Both groups showed improvements in their Nurick grade and Japanese Orthopedic Association score postoperatively, but only the improvement in the Nurick grade for the ECL group was statistically significant (P < .05). The cervical range of motion between C2 and C7 was reduced by 75% in the CLF group and by only 20% in the ECL group in a comparison of preoperative and postoperative range of motion. The overall increase in canal area was significantly (P < .001) greater in the CLF group, but there was a suggestion that the adjacent level was more narrowed in the CLF group in as little as 1 year postoperatively. CONCLUSION: In many respects, ECL compares favorably to CLF. Although the patient numbers were small, there were significant improvements in pain measures in the ECL group while still maintaining range of motion. Restoration of spinal canal area was superior in the CLF group.

Finite-Element Study of Biomechanical Explanations for Bone Loss around Dental Implants

2020 ◽  
Vol 30 (1) ◽  
pp. 21-30
Author(s):  
Ali Merdji ◽  
Belaid Taharou ◽  
Rajshree Hillstrom ◽  
Ali Benaissa ◽  
Sandipan Roy ◽  
...  
Keyword(s):  
Finite Element ◽  
Bone Loss ◽  
Dental Implants ◽  
Finite Element Study ◽  
Element Study

scholarly journals Finite Element Study on Calculation of Nonlinear Soil Consolidation Using Compression and Recompression Indexes

2020 ◽  
Vol 10 (14) ◽  
pp. 4737
Author(s):  
Chao Xu ◽  
Suli Pan
Keyword(s):  
Finite Element ◽  
Case History ◽  
Time Dependent ◽  
Discrete Equation ◽  
Soil Consolidation ◽  
Coefficient Of Consolidation ◽  
Finite Element Study ◽  
Nonlinear Consolidation ◽  
Element Study

The coefficient of consolidation is traditionally considered as a constant value in soil consolidation calculations. This paper uses compression and recompression indexes to calculate the solution-dependent nonlinear compressibility, thus overconsolidation and normal consolidation are separated during the calculations. Moreover, the complex nonlinear consolidation can be described using the nonlinear compressibility and a nonlinear permeability. Then, the finite element discrete equation with consideration of the time-dependent load is derived, and a corresponding program is developed. Subsequently, a case history is conducted for verifying the proposed method and the program. The results show that the method is sufficiently accurate, indicating the necessity of considering nonlinearity for consolidation calculations. Finally, three cases are compared to reveal the importance of separating the overconsolidation and normal consolidation. Overall, this study concluded that it is inadequate to consider just one consolidation status in calculations, and that the proposed method is more reasonable for guiding construction.

scholarly journals Gender disparities in opioid treatment progress in methadone versus counseling

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Erick Guerrero ◽  
Hortensia Amaro ◽  
Yinfei Kong ◽  
Tenie Khachikian ◽  
Jeanne C. Marsh
Keyword(s):  
United States ◽  
Treatment Outcomes ◽  
Treatment Plan ◽  
Dropout Rate ◽  
The United States ◽  
Gender Disparities ◽  
Opioid Use ◽  
Lower Odds ◽  
Male Clients ◽  
Multi Level

Abstract Background In the United States, the high dropout rate (75%) in opioid use disorder (OUD) treatment among women and racial/ethnic minorities calls for understanding factors that contribute to making progress in treatment. Whereas counseling and medication for OUD (MOUD, e.g. methadone, buprenorphine, naltrexone) is considered the gold standard of care in substance use disorder (SUD) treatment, many individuals with OUD receive either counseling or methadone-only services. This study evaluates gender disparities in treatment plan progress in methadone- compared to counseling-based programs in one of the largest SUD treatment systems in the United States. Methods Multi-year and multi-level (treatment program and client-level) data were analyzed using the Integrated Substance Abuse Treatment to Eliminate Disparities (iSATed) dataset collected in Los Angeles County, California. The sample consisted of 4 waves: 2011 (66 SUD programs, 1035 clients), 2013 (77 SUD programs, 3686 clients), 2015 (75 SUD programs, 4626 clients), and 2017 (69 SUD programs, 4106 clients). We conducted two multi-level negative binomial regressions, one per each outcome (1) making progress towards completing treatment plan, and (2) completing treatment plan. We included outpatient clients discharged on each of the years of the study (over 95% of all clients) and accounted for demographics, wave, homelessness and prior treatment episodes, as well as clients clustered within programs. Results We detected gender differences in two treatment outcomes (progress and completion) considering two outpatient program service types (MOUD-methadone vs. counseling). Clients who received methadone vs. counseling had lower odds of completing their treatment plan (OR = 0.366; 95% CI = 0.163, 0.821). Female clients receiving methadone had lower odds of both making progress (OR = 0.668; 95% CI = 0.481, 0.929) and completing their treatment plan (OR = 0.666; 95% CI = 0.485, 0.916) compared to male clients and receiving counseling. Latina clients had lower odds of completing their treatment plan (OR = 0.617; 95% CI = 0.408, 0.934) compared with non-Latina clients. Conclusions Clients receiving methadone, the most common and highly effective MOUD in reducing opioid use, were less likely to make progress towards or complete their treatment plan than those receiving counseling. Women, and in particular those identified as Latinas, were least likely to benefit from methadone-based programs. These findings have implications for health policy and program design that consider the need for comprehensive and culturally responsive services in methadone-based programs to improve outpatient treatment outcomes among women.

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