Effect of microscopically assisted decompression with micro-hook scalpel in the surgical treatment of ossification of the posterior longitudinal ligament

Concept of photonic hook scalpel generated by shaped fiber tip with asymmetric radiation

Structured light have made deep impacts on modern biotechnology and clinical practice, with numerous optical systems and lasers currently being used in medicine to treat disease. We demonstrate a new concept of fiber-based optical hook scalpel. The subwavelength photonic hook is obtained in the vicinity of a shaped fiber tip with asymmetric radiation. A 1550 nm continuous-wave source, commonly used for medical imaging, has been required. Photonic hook with a lateral feature size less than the half-wavelength is achieved using a hemispherical shaped fiber tip with metallic mask. This breakthrough is carried out in ambient air by using a 4-μm-diameter fiber with a shaped tip. A good correlation is observed between the computed intensity distribution of photonic hook and the tip sizes. Photonic hook generated with a shaped fiber tip, easier to manipulate, shows far-reaching benefits for potential applications such as ophthalmic laser surgery, super-resolution microscopy, photolithography and material processing.

Comparative Effectiveness and Safety of Anterior Cervical Corpectomy with Fusion, Laminoplasty, and Laminectomy and Instrumented Fusion for Ossification of the Posterior Longitudinal Ligament: A Systematic Review and Network Meta-Analysis

BACKGROUND

To evaluate the comparative effectiveness and safety of anterior cervical corpectomy with fusion (ACCF), laminoplasty (LP), and laminectomy and instrumented fusion (LF) in the treatment of ossification of the posterior longitudinal ligament (OPLL).

METHODS

Embase, Pubmed, and Cochrane library were searched from their date of inception to June 13, 2020. Relevant randomized controlled trials (RCTs) and cohort studies comparing different procedures among ACCF, LP, and LF were identified, data were extracted to perform a network meta-analysis (NMA). The outcomes were the Japanese Orthopedic Association (JOA) score and complications.

RESULTS

We deemed 14 trials eligible, including 877 patients. In NMA, ACCF showed a significant improvement of JOA score compared with LP [MD= -0.89, 95% CI (-1.73, -0.18)], but no significant difference was found when compared LF with ACCF or LP. No significant differences in complications were found when compared LF with LP or ACCF, while ACCF showed significantly higher in complications than LP [OR = 1.99, 95% CI (1.10, 3.35)]. The surface under the cumulative ranking curves (SUCRA) showed that the rank of JOA score improvement is as follows: ACCF (82.5%), LF (79.5%), and LP (2.3%). And the rank of complication rate is as follows: LF (65.8%), ACCF (68.4%), and LP (2.1%).

LIMITATION

The biggest limitation was that none of the included studies were RCTs.

CONCLUSIONS

Despite the higher probability of complications than LP, ACCF was the more recommended procedure for its highest ranking spectrums of JOA score improvement to treat the OPLL.