Search Results

Patients can assess their own back pain using an app on their phone or tablet as effectively as current paper methods, a study from the University of Warwick has shown. The study, published in the open access journal Journal of Medical Internet Research, demonstrates that digital versions of established measurements for assessing back pain are just as reliable and responsive, opening the possibility for their use by patients for routine measurements and clinical trials. The researchers see this study as a necessary first step in the greater use of digital media in clinical settings, in light of recent calls for greater use of such technology by healthcare providers. For health issues that can’t be readily measured, such as pain and depression, clinicians will often use self-assessment to monitor change. In most cases, this will take the form of a paper-based assessment. These go through very thorough validation exercises to ensure that they measure what they intend to robustly and accurately. The researchers created mobile app versions of the most commonly-used measures in back pain trials: the Roland Morris Disability Questionnaire (RMDQ), visual analogue scale (VAS) of pain intensity, and numerical rating scale (NRS). These were developed with support from the University of Warwick Higher Education Innovation Fund with the aim of being used in clinical trials and for routine clinical measurements. Back pain is the number one cause of disability globally, affecting up to 84 per cent of people at some point in their lives. It is estimated that it costs the UK economy billions of pounds each year. Lead author Dr Robert Froud from the University of Warwick Clinical Trials Unit said: “We have taken existing outcome measures and shown that they can be migrated to digital media and used in that format just as effectively as their paper-based versions. Our intention is to develop technology that allows people to securely complete these kinds of assessments on their own phones and tablets in a way that is safe, secure and accurate. “If you can accurately monitor in clinical practice what’s happening to patients’ health, then analytically there is a lot that could be done with the data that will benefit patients. For example, we may be able to detect that particular treatment approaches are working better for certain types of people. We hear a lot about machine learning, but a learning healthcare system is perhaps next. “The implications are quite big because we can aim to scale up. It opens up potential for the development of new instruments and dynamic instruments that adapt to the answers that a user gives. The potential of using digital technology in healthcare settings is quite extraordinary but you can’t do any of that without first having assessments that work robustly and well.” Reliability and responsiveness were used as factors to determine whether their apps were measuring in the way that they should be. Reliability refers to the result of the measure not changing when nothing has changed, while responsiveness refers to a change in the result when a measurable factor has changed. The researchers divided participants in the study into groups depending on whether they had recorded a change in their pain. People who had received treatment for their condition and improved tested the responsiveness of the apps. Those with chronic pain, and less likely to improve, tested the apps for reliability. Digital tests have a number of advantages over paper-based versions, including their low cost, lower carbon footprint, better information security and improving the participant’s experience. Source:https: //www.spinalsurgerynews.com/2019/04/self-assessing-back-pain-by-app-is-just-as-effective-as-traditional-methods/39238

The use of computed tomography (CT) scans has increased dramatically over the last two decades. CT scans greatly improve diagnostic capabilities (which improve clinical outcomes) but they deliver higher radiation doses than other tests. Therefore, radiation protection is a concern, especially among children, who may receive higher radiation doses, are more susceptible to radiation-related malignancies than adults and have more time to show effects from the potential risk. The most common malignancies caused by radioactivity among children and young adults are leukemia and brain tumors. Researchers therefore evaluated leukemia and brain tumor risks following exposure to radiation from CT scans in childhood. For a nationwide group of 168,394 Dutch children who received one or more CT scans between 1979 and 2012, researchers obtained cancer incidence and vital status by record linkage. They surveyed all Dutch hospital-based radiology departments to ascertain eligibility and participation. In the Netherlands, pediatric CT scans are only performed in hospitals. Overall cancer incidence was 1.5 times higher than expected. For all brain tumors combined, and for malignant and nonmalignant brain tumors separately, dose-response relationships were observed with radiation dose to the brain. Relative risks increased to between two and four for the highest dose category. The researchers observed no association for leukemia. Radiation doses to the bone marrow, where leukemia originates, were low. The researchers caution that this pattern of excess cancer risk may be partly due to confounding by indication, because the incidence of brain tumors was higher in the cohort than in the general population. CT scans are sometimes used to identify conditions associated with an increased tumor risk; the reason these children had CT scans may be associated with their risk of developing cancer. "Epidemiological studies of cancer risks from low doses of medical radiation are challenging, said the study's principal investigator, Michael Hauptmann. "Nevertheless, our careful evaluation of the data and evidence from other studies indicate that CT-related radiation exposure increases brain tumor risk. Careful justification of pediatric CT scans and dose optimization, as done in many hospitals, are essential to minimize risks." Kaynak: https://www.sciencedaily.com/releases/2018/07/180719085337.htm

At the time of writing this Special Feature, there are over 2,700,000 confirmed cases of COVID-19 across the globe. According to official reports, the largest numbers of confirmed cases are in the United States, Italy, Spain, and France. However, even the countries that the new coronavirus has hit less aggressively are still under considerable strain. As many as 213 countries and territories have registered COVID-19 cases, and the entire world is buzzing with uncertainty and questions: How long will the pandemic last? What will people’s lives look like once the pandemic is over? At the moment, many countries have taken measures — some of them stringent — to slow down the spread of SARS-CoV-2, the virus that causes COVID-19. While some of these countries are now considering whether to ease the measures, others have already decided to keep them in place over the following weeks.In this Special Feature, we look at how the pandemic and the measures taken to curb it have impacted communities all over the world. To this end, we have spoken to people from many different countries and asked them about their own experiences. Too little, too late? Many countries have declared restrictive measures, such as lockdown, shelter in place, or stay at home orders, to contain the pandemic at a local level. However, the wildly differing responses and response timelines have left people wondering if authorities failed to take the situation seriously early on when they could have done more to slow down the spread of the coronavirus. China appeared to manage the coronavirus outbreak effectively, putting in place early travel bans within the country itself. As early as January 23, Chinese authorities declared a nationwide travel ban, which, some experts suggest, may have averted over 700,000 COVID-19 cases within the country. Earlier in April, China eased the lockdown measures in Wuhan, the original epicenter of the new coronavirus outbreak, amid celebrations that the nation had beaten the virus. Nevertheless, a recent study assessing the likely number of COVID-19 deaths in the country suggests that the virus may have hit even harder than the authorities initially thought. Given the development of the situation in China, many people have been questioning the appropriateness of measures that other countries around the world have taken. Earlier in April, Japan’s Prime Minister Shinzo Abe declared a state of emergency. This allowed the authorities to ask people to stay at home, though the government has not enforced closures or restrictions. This state of emergency should remain in place until early May, though the steady number of COVID-19 cases has reportedly moved doctors in Japan to warn of an impending breakdown in their health care system. Japan state of emergency filled with ‘ambiguity’ People in Japan have also started to express worry that the government is not doing enough to contain the crisis. Chris, who recently moved to Japan from Europe, has spoken to Medical News Today. He told us what the state of emergency looked like in Yokohama, where he currently lives. “Effectively, the government has requested that businesses and schools close where possible or promote [working from home] … but it can only request, it can’t actually make it a law,” Chris told us. “Whilst many large businesses in Yokohama (especially around the big train stations) appear to have complied with the request, the trains are still pretty cramped during rush hour, and some restaurants and cafes are remaining open,” he added. Chris told MNT that the lack of a stricter response from the authorities means that it can be hard to comply with the advised measures. “[Although] supermarkets are promoting social distancing measures at the tills (with spaced markers, and transparent plastic screens to protect the cashiers), within the stores themselves, with the narrow aisles, it’s impossible to keep your distance from other people,” he said. “[L]earning the news [from] abroad [about the pandemic], I […] became more stressed [before] the announcement of the declaration [of a state of emergency] which was made in April, due to the lack of carefulness of people in Japan (for example, group-shopping at the supermarkets, social drinking, etc.),” Misato, who lives near Tokyo, also told us. ‘Mask gives me a sense of security, even though it doesn’t do much’ Some European countries have reacted sooner to the steep rise in COVID-19 cases than others. On March 10, Italy ordered a strict nationwide lockdown, becoming the first country in Europe to do so. The government banned all travel in the country, and people could only leave their homes for essential reasons — such as to buy food. When going out, people had to carry declaration forms and wear face masks and disposable gloves. Despite a slowdown in the growth of new COVID-19 cases, the Italian government has recently extended lockdown measures through May 3. Laura, who lives in the Italian region of Friuli Venezia Giulia, told MNT: “We can’t go out or travel to other cities, […] we must stay at home. Only one family member may go out at once and only for valid reasons, such as doing the groceries, going to the pharmacy, or the post office for urgent matters.” “I comply with the rules imposed by the government, and I only go out when I have to, wearing a mask and gloves. Now that it’s warmer outside, the mask has become a little bothersome, but it gives me a sense of security, even though I know that, in reality, it doesn’t do much.” – Laura, Italy Spain, another one of the European countries hit badly by the coronavirus, also announced strict lockdown measures from March 14. Although there have been over 208,000 confirmed COVID-19 cases in the country to date, Spain’s Prime Minister Pedro Sanchez announced that Spain reached the peak of the pandemic in early April. “Both my boyfriend and I had symptoms compatible with COVID-19 and we [self-isolated] throughout that time (nearly 10 days each), avoiding any physical contact with each other (while living together),” Susana, from Madrid, Spain, told MNT. Susana said that she managed to stay optimistic despite the illness. Yet, like many, she is concerned about the economic and emotional impact of the lockdown in response to the pandemic: “I worry about the impact this crisis has on many families that have been highly affected and are suffering at different levels, [such as the] loss of relatives, loss of jobs and so on.” The Spanish government appears to share such worries and is considering easing these measures in May, despite criticism that it is still unclear how the pandemic may progress in the country. Sweden: ‘Not a true form of self-isolation’ Other European countries have put in place less stringent measures. For instance, in the United Kingdom, Prime Minister Boris Johnson announced a lockdown on March 23, though the measures have been less stringent than in other countries. Unlike in Italy, for instance, in the U.K., people may go out without a declaration form. The acceptable reasons for leaving one’s home — “for food, health reasons or work” — has received criticism for being confusing and lacking clarity. Some, however, relish the relative freedom that Britain’s more relaxed pandemic advice has afforded. Harry, who lives in Brighton, U.K., told MNT: “Britain’s less rigid approach to the lockdown compared to other European countries is crucial to maintaining my [mental] as well as physical health. As it is, I [can] stay active, get sunlight and air, and avoid being stuck in the same place all day.” At the same time, practitioners in the U.K.’s National Health Service (NHS) have been bracing for a severe strain on the NHS’s resources, as hospitals are cracking under the pressure of increasing numbers of COVID-19 cases. Other European countries, such as Sweden, which have reported fewer cases of COVID-19 overall, have fewer and much less restrictive measures in place. People who live in Sweden have been staying more or less put, mostly following their own judgment. Simona, based in Malmö, told MNT that “Sweden does not impose any quarantine [measures], just [physical] distancing, but I have been sort of — partially — self-isolating together with my partner.” “We do get out to shop, meet friends sometimes, or walk in the sun, so it is by no means a true form of self-isolation,” she adds. Yet, some experts worry that the authorities have underestimated the incidence of COVID-19 in Sweden. Others suggest that the guidelines have left older citizens — one of the high-risk categories — unnecessarily exposed to the virus. The one country that has received consistent kudos for its approach to the pandemic appears to be Finland, where Prime Minister Sanna Marin announced, on April 22, a “composite strategy.” This strategy would involve a gradual easing of lockdown measures while increasing COVID-19 testing. Testing will ensure that anyone exposed to the coronavirus receives the care they need, while those who have not had exposure may return to their normal life, little by little. ‘I’ll never know if I had COVID-19’ The U.S. strategy in dealing with the pandemic has been the target of an increased amount of criticism since different states have adopted wildly different measures. There is a lack of consensus between the authorities and various public health organizations. As of March 30, 30 U.S. states — including New York, California, Texas, and Washington — have directed their citizens to shelter in place or stay at home, though some have opted for less restrictive measures. Since March 31, the Department of State has been advising all U.S. citizens “to avoid all international travel.” Although measures in the U.S. have been, overall, less stringent than elsewhere, groups of people in 18 states have been protesting against the lockdown. They claim that the measures have been harming them financially and otherwise. Even President Donald Trump has spoken in favor of easing the current measures, saying that the pandemic has already peaked in the U.S. However, some medical professionals have spoken out against the protests, stressing that the protesters may well be putting other people’s lives and health in danger. In Canada, only two provinces — Ontario and Alberta — declared a state of emergency in the first half of March, following an increase in the number of COVID-19 cases. One reported worry among experts and the public is that Canadian authorities have not managed to capture important health data and that testing efforts for COVID-19 are falling short. The extent to which the country is being affected by the new coronavirus remains unclear. Stephen, who lives in the Province of Ontario, told MNT that despite having had symptoms that may have been consistent with COVID-19, he did not have access to testing to verify whether that was actually the case: “Early on during the lockdown, I was ill for a few days with cold and flu-like symptoms. The advice here is to stay home and self-isolate for 14 days if you’re ill and not to go to a clinic unless the symptoms progress. So I guess I’ll never know if I had COVID-19, though I suspect it was probably just a cold.” Kaynak: https://www.medicalnewstoday.com/articles/covid-19-global-impact-how-the-coronavirus-is-affecting-the-world#Physical-and-mental-health-in-jeopardy

A new technology that increases the safety and precision of spinal fusion surgeries while reducing the time needed for the procedure now is available at Rush University Medical Center. Called the Mazor X Robotic Guidance Platform, the technology combines imaging prior to surgery and image guidance during the procedure, which enhances surgical planning and precision. Spinal fusion is used to relieve pain and other symptoms for conditions including tumors, fractures, spinal stenosis, scoliosis, spondylolisthesis and degenerative disc disease. During spinal fusion, vertebrae (the bones of the backbone) are fused together, eliminating motion between the vertebrae. Rush is the first hospital in Chicago to use the robotic platform, which has an imaging component that provides a customized 'blueprint' of a patient's spine along with detailed locations for spinal screws. The robotic platform attaches to the operating room table as well as the patient and includes a robotic arm that helps guide the surgeon as he or she places the screws into the proper locations. "Because the robotic system makes placing screws more efficient, I am able to focus on different aspects of the procedure, such as deformity correction and decompression of nerves. The entire surgery can be completed in a shorter period of time," DeWald said. Another benefit of robotic spinal fusion surgery is it decreases both a patient and surgeon's exposure to radiation, because the surgeon can depend less on X-ray imaging for guidance during surgery. The technology allows for the images taken during surgery to be matched with a computerized tomography (CT) scan taken prior to the procedure with submillimetric accuracy. The robot is able to match the patient's position during surgery with the pre-operative CT scan. Kaynak:https://www.news-medical.net/news/20190603/New-robotic-technology-increases-the-safety-and-precision-of-spinal-fusion-surgeries.aspx

New research by scientists at the Lewis Katz School of Medicine Temple University (LKSOM) shows, however, that gains in functional recovery from these injuries may be possible, thanks to a molecule known as Lin28, which regulates cell growth. In a study published online in the journal Molecular Therapy, the Temple researchers describe the ability of Lin28 -- when expressed above its usual levels -- to fuel axon regrowth in mice with spinal cord injury or optic nerve injury, enabling repair of the body's communication grid. "Our findings show that Lin28 is a major regulator of axon regeneration and a promising therapeutic target for central nervous system injuries," explained Shuxin Li, MD, PhD, Professor of Anatomy and Cell Biology and in the Shriners Hospitals Pediatric Research Center at the Lewis Katz School of Medicine at Temple University and senior investigator on the new study. The research is the first to demonstrate the regenerative ability of Lin28 upregulation in the injured spinal cord of animals. "We became interested in Lin28 as a target for neuron regeneration because it acts as a gatekeeper of stem cell activity," said Dr. Li. "It controls the switch that maintains stem cells or allows them to differentiate and potentially contribute to activities such as axon regeneration." To explore the effects of Lin28 on axon regrowth, Dr. Li and colleagues developed a mouse model in which animals expressed extra Lin28 in some of their tissues. When full-grown, the animals were divided into groups that sustained spinal cord injury or injury to the optic nerve tracts that connect to the retina in the eye. Another set of adult mice, with normal Lin28 expression and similar injuries, were given injections of a viral vector (a type of carrier) for Lin28 to examine the molecule's direct effects on tissue repair. Extra Lin28 stimulated long-distance axon regeneration in all instances, though the most dramatic effects were observed following post-injury injection of Lin28. In mice with spinal cord injury, Lin28 injection resulted in the growth of axons to more than three millimeters beyond the area of axon damage, while in animals with optic nerve injury, axons regrew the entire length of the optic nerve tract. Evaluation of walking and sensory abilities after Lin28 treatment revealed significant improvements in coordination and sensation. "We observed a lot of axon regrowth, which could be very significant clinically, since there currently are no regenerative treatments for spinal cord injury or optic nerve injury," Dr. Li explained. One of his goals in the near-term is to identify a safe and effective means of getting Lin28 to injured tissues in human patients. To do so, his team of researchers will need to develop a vector, or carrier system for Lin28, that can be injected systemically and then hone in on injured axons to deliver the therapy directly to multiple populations of damaged neurons. Dr. Li further wants to decipher the molecular details of the Lin28 signaling pathway. "Lin28 associates closely with other growth signaling molecules, and we suspect it uses multiple pathways to regulate cell growth," he explained. These other molecules could potentially be packaged along with Lin28 to aid neuron repair. Kaynak: https://www.sciencedaily.com/releases/2020/04/200430113041.htm

lNina Fisher, M.D., from NYU Langone Orthopedic Hospital in New York City, and colleagues used electronic medical recordsto identify 5,030 patients undergoing orthopedic trauma, spine, and adult reconstruction procedures between 2012 and 2015. The authors examined associations between patient-reported pain scores at discharge and narcotic use during the 90-day postoperative period. The researchers found that spine patients had the longest length of stay, experienced the highest mean pain during length of stay, and were prescribed the most morphine in the 90-day postoperative period. Pain scores at discharge markedly impacted the quantity of narcotics prescribed in the 90-day postoperative period. "We're performing surgeries to alleviate pain, so it's important to have a greater understanding of high-risk populations to help orthopedic surgeons safely address pain management following surgery," a coauthor said in a statement. "We can obtain a pain management consult before discharge to lower their visual analog scale pain score or use a multimodal analgesia protocol (a regimen of nonopioids and anesthesia to minimize the use of perioperative opioids) during surgery." https://medicalxpress.com/news/2020-07-spine-surgery-patients-postoperative-narcotics.html

Safe, tissue-sparing and efficient The operation is performed with minimal trauma to any surrounding tissue, as muscles, ligaments and tendons need not be disrupted. Faster recovery of the patient: Clinical studies have shown a quicker return to work1,2 after endoscopic disc surgery. In the current economic climate, patients are interested in returning to work as quickly as possible. So the advantages perceived by the patient might possibly lead to an increase of patient numbers and referrals when offering this kind of minimally invasive spine surgery procedures. Patients require much less anesthesia during minimally invasive surgeries or even can be treated with analgesic sedation – so the patient is conscious during surgery and the surgeon is able to see directly the patient’s reaction to possible pain. Sophisticated technology “Made in Germany”: Optimal visualization of the surgical field in HD quality; throughout the operation the camera at the end of the endoscope provides large-scale images of the operative field allowing the surgeon to perform the surgery through a minor incision while watching it on the monitor. Especially adapted instrumentation developed in close cooperation with experienced surgeons. https://www.joimax.com/us/professionals/endoscopic-spine-surgery/

Everard Munting, president of EUROSPINE, talks about the growing need for an international approach to information sharing in the field of spinal surgery. Spinal surgery has come a long way since Hippocrates proposed the first traction procedure in 390 BC. The challenges the medical fraternity faced back then were very different to those clinicians are addressing now. Today we live in a world that often seems to place less emphasis on movement and activity than ever before and the impact on spinal health is evident to anyone working in this field. The pandemic has only exacerbated the problem. Research by Ofcom found adults in the UK during the lockdowns have been spending more than 40 per cent of their waking day on their devices, a trend echoed throughout the world. This, along with our ageing population, will only contribute to the continuing issues patients experience with neck and spinal health. Driving innovation On the plus side, there have been huge advances made over the last four decades in minimally invasive surgical techniques. A report by Allied Market Research projects the global spinal implants and devices market will increase to over $15 billion by 2027. This is a highly competitive market with new technologies and products being pioneered and developed all the time to increase market share and improve patient health and mobility. However, at the moment, it’s hard for practitioners to independently determine which procedures with or without implantable devices might work best for individual patients and why. Concern about possible complications is a major worry for patients, their families and the medical profession. But the pandemic has taught us there is a simple way to develop practices and get the right help to patients more quickly. A global understanding Covid-19 underlined the importance of sharing real-world evidence on the impact of health issues in the population and escalated the development of effective treatments and a vaccine. Pooling health data on a global scale has resulted in multiple vaccinations being developed in record time and informed techniques used in intensive care, which for some patients has meant the difference between life and death. Could it be time for a more collaborative approach to driving innovation in our specialism? There’s a growing case for introducing an effective way for clinicians, manufacturers, health insurances – private and public – and medical regulators to amalgamate and share their collective knowledge to increase patient safety and mitigate concern. The danger of working in siloes The Cumberlege Review threw a spotlight on the negative impact of information siloes across healthcare and called for an end to disjointed working in the sector. A key point emphasised in the report was that better information sharing leads to better decision making and improved patient safety. As a result, it’s now widely accepted that sharing data on a national basis is essential, as it allows doctors and surgeons to see which treatments and devices work best for which type of patient. However, there could be even greater advantage to taking this a step further and encouraging the sharing of information on a global scale, just as the medical research teams involved in the development of Covid-19 treatments have done. Being able to access a larger collection of data on the spinal procedures taking place and their impact on different sets of patients would provide valuable insight into the most effective ways to improve outcomes. Surgeons could look at the experiences of patients presenting with similar clinical characteristics and being treated using a range of approaches and devices, then use this information to make informed decisions on the best course of action to take based on the latest evidence. Which procedures work best with very elderly patients and which work more effectively for the young, for example. Being able to draw upon a much more in-depth archive of knowledge from across the world will help to identify which treatments are most likely to result in better outcomes for subgroups of patients too, such as those with kidney conditions or morbid obesity where there may be a greater risk of poorer outcomes. Big picture thinking SIRIS, the Foundation for Quality Assurance in Implant Surgery in Switzerland, has already set up a national registry with the longer-term aim of gathering evidence on implant performance. It is tracking and monitoring outcomes of patients undergoing spinal treatment. But rather than creating a new registry database, SIRIS is using EUROSPINE’s established international registry platform, Spine Tango, built on technology provided by Northgate Public Services. This means SIRIS will easily be able to compare treatments and outcomes with other international centres already participating in the Spine Tango registry. Sharing evidence in this way will provide a much higher level of assurance and evidence than is possible on a purely national scale, arming surgeons, hospitals and medical device manufacturers with real-world evidence from around the globe to maximise the chance of achieving a positive outcome for patients. The backbone of safety There can be little doubt as to the complexity and multifaceted nature of spinal surgery, not only because of the patient demographics but also the evolving trends. Various studies have shown that disc degeneration affects 96 per cent of those in their 80s and as we are all too aware, pain and impaired movement are the clinical expressions of an ageing spine. The average global age is set to reach 73 in just four years’ time, compared to 48 years in 1955, meaning more people than ever before will require spinal surgery in one form or another. If classifying and recording the various diagnosis, along with the effectiveness of the different surgical procedures involving or not implants, was done in a more cohesive way, this would allow for a wealth of information to be captured securely within a global implant library. With a more substantial, evidence-based approach, where data is collated from across all the different hospitals, countries and patient groups within the national registries and information is housed on an international platform, there would be greater scope for comparison and increased efficacy and safety. Beyond a national snapshot Powerful, actionable insight on this scale would improve research and analysis in the specialism and increase transparency. And with the right systems in place, that automatically gather and store the most appropriate data centrally, there would be no added administrative burden on individual hospitals. A more comprehensive set of data would reduce the risk of failing implants, or poor surgical procedures being overlooked and ensure earlier action could be taken when things go wrong. Only by pooling international knowledge will we be able to predict the long-term success of treatments, drive up clinical standards and foster patient trust by improving safety and outcomes.https://www.spinalsurgerynews.com/2021/04/why-its-time-to-back-global-evidence-to-improve-outcomes-for-spinal-patients/73007

Study results presented at the 2021 annual meeting of the Orthopaedic Research Society (12–16 February, virtual) report that a radioactive bone cement could provide a safer alternative to conventional radiation therapy for bone tumours. The study was conducted at the University of California, Irvine (UCI; Irvine, USA). Researchers used animal and computation studies to evaluate the short-term safety of injecting brachytherapy cement into vertebrae; the possible migration of radioactivity into blood, urine or faeces; the dose rate outside the injection site; and the radiation dose from phosphorus-32 emissions to the spinal cord and soft tissue. According to researchers, at 12 weeks post-injection physical examinations were normal and they found no evidence of the phosphorus-32 isotope circulating in the blood, and no changes in blood work related radioactivity or neurological deficits. Lead researcher Joyce Keyak, UCI professor of radiological sciences, commented, “This localised treatment for bone tumours stays localised, and we did not see any effects outside the bone.” She continued, “This is important because traditional radiation therapy causes adverse effects such as nausea, vomiting and diarrhoea.” According to a press release from UCI, current treatments for this cancer include multiple sessions of external beam radiation on the spine. UCI adds that in addition to the unpleasant side-effects of radiation, the treatment can threaten the spinal cord and weaken the bones already compromised by a tumour’s erosion, increasing the risk of fracture. “Brachytherapy cement could be used without delay in a convenient, one-step, minimally invasive treatment to irradiate tumours,” Keyak said, “and would not irradiate the spinal cord or limit future treatment options.” Keyak noted that brachytherapy bone cement does not have the same side-effects as radiation therapy because the injection directly targets the tumour and radiation does not pass through other organs, such as the intestines or stomach. According to Keyak, a bone cancer patient may need 10 or more sessions of radiation therapy, but with the brachytherapy bone cement a single injection can provide an equivalent, targeted tumour treatment with significantly less threat to the spinal cord and nerves. Brachytherapy cement was created by Keyak and Harry Skinner (St. Jude Heritage Medical Group, Corona del Mar, USA), by infusing bone cement with radioactive material used in other treatments. The product is produced by their company Bone-Rad Therapeutics, and has four patents and one patent pending. The next step, Keyak said, will be more animal studies, followed by an application for a clinical trial. https://spinalnewsinternational.com/brachytherapy-cement-could-be-used-to-treat-spinal-tumours/

N2 Biomedical has announced that the first polyetheretherketone (PEEK) interbody fusion device coated with its titanium coating technology was successfully implanted in a patient. This coating forms part of the company’s NanoTitanium family of coatings. According to N2 Biomedical, the titanium coating is less than a micrometre thick and is deposited using an advanced vacuum coating technology known as Ion Beam Assisted Deposition (IBAD), a process which combines evaporation with concurrent ion bombardment to provide coating adhesion and control over properties such as surface morphology and coating density. A company press release states that PEEK is frequently used to fabricate orthopaedic and spinal devices, in part due to its chemical inertness, radiolucency, and an elastic modulus that is closely matched to natural bone. However, PEEK surfaces provide relatively poor bone tissue attachment compared to titanium-based devices, which can reduce the probability of a successful fusion. N2 Biomedical claim numerous scientific studies have shown that titanium coatings on PEEK can promote and increase new bone growth and result in stronger bone attachment, however, recent studies have also shown that the thicker thermal plasma spray (TPS) titanium coatings commonly used on PEEK implants can liberate titanium particles upon impaction, leading to complications such as phagocytosis. The company reports that to overcome the drawbacks of thick porous titanium coatings, there is growing interest in very thin (about one micron or less) titanium coatings on PEEK-based devices deposited using atomic-level deposition techniques such as IBAD, rather than through bonding or agglomeration of large titanium particles at high temperature. N2 Biomedical claims its titanium coating provides these advantages while passing all of the requisite standardised mechanical adhesion and durability tests. Eric Tobin, CEO of N2 Biomedical (Bedford, USA), states: “We are very excited to see our titanium coating utilised for the first time in a clinical application. This is the culmination of a significant effort made by numerous individuals both at N2 and the device manufacturer. PEEK spinal interbody devices are an ideal application for this coating, and its clinical utilisation supports N2’s core mission of enhancing performance of our customers’ devices with advanced technology. Our coatings have a wide array of uses in orthopaedic and spinal devices, and we look forward to further expanding application of these coatings in a range of surgical procedures.” https://spinalnewsinternational.com/first-surgical-implant-of-spinal-device-coated-with-n2-biomedicals-ion-assisted-titanium-coating-technology/