Shoaib Khan

Level structure above the 17+ isomeric state in Tm8369152

B. S. Nara Singh,1,* D. M. Cullen,1 M. J. Taylor,1,2 P. C. Srivastava,3,4 P. Van Isacker,3 O. Beeke,1 B. Dodson,1 C. Scholey,5 D. O’Donell,6 U. Jakobson,5,7 T. Grahn,5 P. T. Greenlees,5 P. M. Jones,5,8 R. Julin,5 S. Khan,1 M. Leino,5 A.-P. Leppänen,5,9 S. Eeckhaudt,5 K. Mäntyniemi,5 J. Pakarinen,5 P. Peura,5,10 P. Rahkila,5 J. Sarén,5 J. Sorri,5,11 J. Uusitalo,5 and M. Venhart12 1Schuster Building, School of Physics and Astronomy, The University of Manchester, Manchester M13 9PL, United Kingdom 2Division of Cancer Sciences, The Univserity of Manchester, Manchester M13 9PL, United Kingdom 3Grand Accélérateur National d’Ions Lourds, CEA/DRF-CNRS/IN2P3, Boulevard Henri Becquerel, F-14076 Caen, France 4Department of Physics, Indian Institute of Technology Roorkee, Roorkee 247 667, India 5University of Jyvaskyla, Department of Physics, P.O. Box 35, FI-40014 University of Jyvaskyla, Finland 6School of Computing, Engineering and Physical Sciences, University of the West of Scotland, Paisley, PA1 2BE, United Kingdom 7Department of Chemistry-Radiochemistry, P.O. Box 55, FI-00014 University of Helsinki, Finland 8Department of Nuclear Physics, iThemba Laboratory for Accelerator Based Sciences, P.O. Box 722, Somerset West 7129, South Africa 9STUK, Radiation and Nuclear Safety Authority, Finland 10Helsinki Institute of Physics, FI-00014, University of Helsinki, Finland 11University of Oulu, Sodankylä Geophysical Observatory, Tähteläntie 62, FI-99600 Sodankylä, Finland 12Institute of Physics, Slovak Academy of Sciences, Dúbravská cesta 9, 845 11 Bratislava, Slovakia

Long-term results of multilevel (three and four levels) cervical disc arthroplasty: age-weighted linear regression analysis—results from a single centre

IntroductionThe clinical outcomes of Multi-level disc arthroplasties are variable in the literature. However, the outcome results related to age would have a significant bearing on our decisions in...

Transforaminal Lumbar Interbody Fusion or Posterior Lumbar Interbody Fusion: Which is Better? A Single-Centre Study

Introduction The first lumbar spinal fusion was introduced over 70 years ago and techniques have been evolving since then. Two popular techniques are Transforaminal Lumbar Interbody Fusion (TLIF) and Posterior Lumbar Interbody Fusion (PLIF). However, it is still controversial which is better. The aim of this study was to compare the clinical and radiological outcomes of those techniques. Material and Methods We retrospectively reviewed our spinal unit database to identify the patients who underwent TLIF and PLIF over the last 1 year. A hundred and ten patients were identified (54 TLIF, 56 PLIF). Demographics, Visual analogue score for leg and back pain and SF36 scores were analyzed preoperatively, at six weeks, six months and twelve months postopertively. Two independent reviewers assessed the X-rays for fusion at twelve months postoperatively using the Brantigan-Steffee classification. Results With regards to the clinical outcomes, TLIF patients had significantly better outcomes at six weeks with lower visual analogue scores (VAS) and better SF36 scores. The difference between the two groups has significantly reduced after one year. Both TLIF and PLIF patients had excellent lumbar spine fusion on X-rays at one year with good interobserver reliability (Kappa = 0.95) Conclusion Both TLIF and PLIF are excellent techniques for lumbar spinal fusion. There are no significant differences in the clinical and radiological outcomes between the two techniques at one year.

Outcomes of Decompression and Stabilization with a Pedicle-Based Semirigid Posterior Stabilization System in the Lumbar Spine

Introduction Patients with lumbar spinal stenosis who do not respond satisfactorily to nonoperative measures may require decompression. Laminectomies/decompression without instrumentation may cause instability and associated symptoms. Fusion often involves multiple segments potentially increasing the risk of proximal junctional kyphosis (PJK), adjacent segment disease (ASD), and surgical morbidity of lateral exposure to prepare fusion bed. We have therefore been using the TRANSITION Stabilization System (Globus Medical, Inc., Audubon, Pennsylvania, United States) to provide stability without fusion at the operated levels. Following insertion of pedicle screws, to which the rod is attached, a semirigid rod is custom built along a central cord using a combination of rigid screw head attachments, flexible spacers, and a compressible bumper. Biomechanical studies have indicated superior performance to other similar systems. We report our clinical results. Patients and Methods A retrospective analysis of prospectively collected data was performed for patients who underwent surgery between September 2011 and December 2013. Outcome measures included Oswestry Disability Index (ODI), Visual Analog Scale (VAS) back/leg pain, Hospital Anxiety and Depression Scale, and complications. Statistical analysis was performed with paired and unpaired tests. Results Demographics: Data were available for 24 patients; 8 females and 16 males. Mean age at surgery was 66.8 years. Mean body mass index was 30.4 kg/m2. Mean length of follow-up was 44 (range, 10–109) weeks. Mean postoperative length of stay was 7.2 days, and when those patients requiring reoperation for complications were excluded it was 4.4 days. Surgery: A total of 10 L3–S1, 4 L4–S1, 1 L4–L5, 3 L2–L5, 4 L3–L5, 1 L1–L5, and 1 L2–S1 stabilizations were performed with a variety of combined central and foraminal decompressions. Mean blood loss was 648 mL and surgical time 176 minutes. Eight patients sustained intraoperative dural tears that were sealed with fibrin sealant. Outcomes: Mean ODI improved from 45.1 to 31.3 (p = 0.001), VAS back from 6.7 to 3.7 (p ≤ 0.01), VAS legs from 6.7 to 2 (p ≤ 0.01), anxiety from 6.1 to 5.4 (p = 0.37), and depression from 7.3 to 3.7 (p = 0.033). There was no statistical correlation between pre- and postoperative ODI, VAS back or legs, depression/anxiety scores, and demographics. Reoperations: There were three early reoperations: one patient for discharging wound with positive microbiology and for revision of a screw, one patient for discharging wound with negative microbiology, and one patient for revision of a screw. There were no implant failures or revisions for PJK or ASD to date. Conclusion Our results using the TRANSITION Stabilization System suggests that pedicle-based semirigid posterior stabilization systems warrant further consideration as a potential tool in providing satisfactory early postoperative results while potentially reducing the long-term morbidity associated with fusions for lumbar stenosis. We would encourage further research to assess longer term results and radiographic outcomes.