Safety and effectiveness of a polyvinyl alcohol barrier in reducing risks of vascular tissue damage during anterior spinal revision surgery

Unidirectional Nanopore Dehydration Induces an Anisotropic Polyvinyl Alcohol Hydrogel Membrane with Enhanced Mechanical Properties

As a biocompatible, degradable polymer material, polyvinyl alcohol (PVA) can have a wide range of applications in the biomedical field. PVA aqueous solutions at room temperature can be cast into very thin films with poor mechanical strength via water evaporation. Here, we describe a novel dehydration method, unidirectional nanopore dehydration (UND). The UND method was used to directly dehydrate a PVA aqueous solution to form a water-stable, anisotropic, and mechanically robust PVA hydrogel membrane (PVAHM), whose tensile strength, elongation at break, and swelling ratio reached values of up to ~2.95 MPa, ~350%, and ~350%, respectively. The film itself exhibited an oriented arrangement of porous network structures with an average pore size of ~1.0 μm. At 70 °C, the PVAHMs formed were even more mechanically robust, with a tensile strength and elongation at break of 10.5 MPa and 891%, almost 3.5 times and 2 times greater than the PVAHM prepared at 25 °C, respectively. The processing temperature affects the velocity at which the water molecules flow unidirectionally through the nanopores, and could, thus, alter the overall transformation of the PVA chains into a physically crosslinked 3D network. Therefore, the temperature setting during UND can control the mechanical properties of the hydrogel membrane to meet the requirements of various biomaterial applications. These results show that the UND can induce the ordered rearrangement of PVA molecular chains, forming a PVAHM with superior mechanical properties and exhibiting a greater number of stronger hydrogen bonds. Therefore, the novel dehydration mode not only induces the formation of a mechanically robust and anisotropic PVA hydrogel membrane with a porous network structure and an average pore size of ~1.0 μm, but also greatly enhances the mechanical properties by increasing the temperature. It may be applied for the processing of water-soluble polymers, including proteins, as novel functional materials.

Biomechanical study comparing a new combined rod-plate system with conventional dual-rod and plate systems

Most anterior spinal instrumentation systems are designed as either a plate or dual-rod system and have corresponding limitations. Dual-rod designs may offer greater adjustability; however, this system also maintains a high profile and lacks a locking design. Plate systems are designed to be stiffer, but the fixed configuration is not adaptable to the variety of vertebral body shapes. The authors designed a new combined rod-plate system (D-rod) to overcome these limitations and compared its biomechanical performance with the conventional dual-rod and plate system. Eighteen pig spinal specimens were divided into 3 groups (6 per group). An L1 corpectomy was performed and fixed with the D-rod (group A; n=6), Z-plate (Sofamor Danek, Memphis, Tennessee) (group B; n=6), or Ventrofix (Synthes, Paoli, Pennsylvania) (group C; n=6) system. T13-L2 range of motion was measured with a 6 degrees of freedom (ie, flexion-extension, lateral bending, and axial rotation) spine simulator under pure moments of 6.0 Nm. The D-rod and Ventrofix specimens were significantly stiffer than the Z-plate specimens (P<.05) based on results obtained from lateral bending and flexion-extension tests. The D-rod and Z-plate specimens were significantly stiffer than the Ventrofix specimens (P<.05) in axial rotation. The D-rod combines the advantages of the plate and dual-rod systems, where the anterior rod exhibits the design of a low-profile locking plate, enhanced stability, and decreased interference of the surrounding vasculature. The posterior rods function in compression and distraction, and the dual-rod system offers greater adjustability and control over screw placement. The results indicate that it may provide adequate stability for anterior thoracolumbar reconstruction.