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Use of Porous Aluminium Oxide Interbody Cages for Interbody Fusion of the Cervical Spine
Kostyšyn, Roman ; Česák, Tomáš (advisor) ; Hrabálek, Lumír (referee) ; Filip, Michal (referee)
Use of porous aluminum oxide interbody cages for interbody fusion of the cervical spine Introduction: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly used methods of surgical treatment for degenerative disease of the cervical spine. The primary goal of the surgery is to decompress the nerve structures. A secondary but equally important goal of the surgery is to provide intervertebral fusion as a prevention of subsequent instability or deformity. The selection of the optimal cage for disc replacement in ACDF takes into account the requirements for the speed and quality of interbody fusion and places demands on its safety. Aims: The objective of this prospective randomized monocentric study was to evaluate the speed and quality of interbody fusion of implanted porous aluminium oxide (Al2O3) cages, and compare with parameters of fusion of polyetheretherketone (PEEK) cages for anterior cervical discectomy and fusion (ACDF). Another aim was to compare the clinical results. Methods: A total of 111 patients were enrolled in the study. The 18-month follow-up was completed in 68 patients with an Al2O3 cage and 35 patients with a PEEK cage in one-level ACDF. Initially, the first evidence (initialization) of fusion was evaluated on computed tomography. Subsequently, interbody fusion...
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Experimental Treatment of the Spinal Cord Injury and Clinical Treatment of Thoraco-Lumbar Vertebral Fractures
Krůpa, Petr ; Řehák, Svatopluk (advisor) ; Hejčl, Aleš (referee) ; Hrabálek, Lumír (referee)
Vertebral body fractures together with the spinal cord injury (SCI) remain a challenging medical condition. While management of the thoracic-lumbar (Th-L) vertebral fractures belongs to basic neurosurgical procedures with a usually excellent outcome, treatment of the severe spinal cord injury has mostly unsatisfactory results and thus novel approaches are highly in demand. In this study, experimental treatment of the SCI in a rat model using human mesenchymal stem cells derived from Wharton's jelly (WJ-MSCs) and a novel highly water soluble, nano-formulated curcumin is evaluated. Furthermore, a novel method of mini- invasive percutaneous posterior stabilisation (MIS) of Th-L vertebral fractures is retrospectively compared with classical open posterior (OPEN) procedure. To assess the effectivity of hWJ-MSCs treatment in the ischemic-compression model of SCI in rats, different dosages (0.5 or 1.5 million cells) and repeated applications were compared. Cells or saline were applied intrathecally by lumbar puncture once, or in three consecutive weeks after injury. Nanocurcumin and a vehicle nanocarrier as a control were delivered both locally, immediately after the spinal cord injury, and subcutaneously during the four consecutive weeks after SCI. Rats were assessed for locomotor skills (BBB, flat beam,...
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