Biomedical subjects

Eric L Lin

Publications and source records attributed to Eric L Lin.

3 recordsLinked to original sources

PubMed2006

Cervical epidural steroid injections for symptomatic disc herniations.

OBJECTIVES: Cervical disc herniations are a common cause of radicular pain from nerve root impingement and may necessitate surgical decompression to alleviate symptoms. The use of cervical epidural injections has not been studied in detail. The objective of this retrospective study was to examine the efficacy of cervical epidural steroid injections for the treatment of symptomatic herniated cervical discs. METHODS: Patients with herniated cervical discs without myelopathy that had failed conservative management and were otherwise surgical candidates were offered a trial of cervical epidural injections. The results and benefits of the injections were examined as well as the incidence of proceeding to surgical intervention. RESULTS: Of the 70 treated patients, 44 (63%) had significant relief of their symptoms and did not wish to proceed with surgical treatment. Of the 26 patients who underwent surgical decompression, 92% had successful resolution of their symptoms. The nonsurgical and surgical groups were similar in terms of gender, preinjection symptoms, or number of injections. However, significant differences between the two groups were found with regard to age (P<0.05) and time from initial consultation to initial injection (P<0.05). With an average of 13-month follow-up, 45 (65.3%) patients reported a good/excellent result per Odom criteria. In addition, 53 (75%) would attempt cervical epidural steroid injections again in the future. No complications were noted in our series. CONCLUSIONS: Cervical epidural injections are a reasonable part of the nonoperative treatment of patients with symptomatic cervical disc herniations. The success rates appear to be very similar to prior studies of lumbar epidural injections for symptomatic lumbar disc herniations. It appears that a large percentage of the patients may obtain relief from radicular symptoms and avoid surgery for the follow-up period up to 1 year. In addition, patients older than 50 years and those who received the injections earlier, less than 100 days from diagnosis, seemed to have a more favorable outcome.

Adult↗

PubMed2006

Total disk arthroplasty.

Spinal fusion remains the gold standard for surgical management of instability and mechanical low back or neck pain. However, even in carefully selected patients, successful clinical results can be difficult to achieve. Reasons for failure include pseudarthrosis and adjacent spine segment disease. The theoretic advantages of removing the painful disk while preserving motion have led to increasing interest in total disk arthroplasty. Although disk replacements have been implanted in Europe for decades, the procedure is relatively new in the United States. Recently, two artificial disks for symptomatic lumbar degenerative disk disease have been approved by the US Food and Drug Administration; several others are undergoing clinical trials. Short-term studies demonstrate similar clinical improvements for both disk replacements and fusion procedures at up to 2-year follow-up. Issues requiring further research include optimal design specifications, potential complications, and appropriate patient selection. Consequently, the long-term benefit of total disk arthroplasty over fusion for the treatment of axial low back or neck pain remains to be determined.

Arthroplasty, Replacement↗

PubMedDate not supplied

Biomechanical analysis of allograft bone treated with a novel tissue sterilization process.

BACKGROUND CONTEXT: Several methods to sterilize allograft bone exist, including gamma irradiation and freeze-drying, which can alter the mechanical properties of the graft. Efforts are under way to develop a method for processing osseous allograft that maintains structural integrity. Herein is presented one such method. PURPOSE: To analyze the mechanical properties, compared with nontreated controls, of a novel sterilization process for allograft cortical bone. STUDY DESIGN/SETTING: A controlled biomechanical evaluation of allograft bone under various types of loading after a novel sterilization treatment. PATIENT SAMPLE: Not applicable; basic science. OUTCOME MEASURES: The load to failure was recorded for both the study and control groups, and statistical analysis of these results was performed. Significance level (alpha) and power (beta) were set to 0.05 and 0.90, respectively. Single-factor analysis of variance (ANOVA) was used to detect significant differences between the treated and untreated groups. A post-experimental power analysis was performed for each of the response variables. METHODS: Cortical tibia and femur samples from seven cadaveric donors (mean age 68.7 years) were treated with Biocleanse and compared with untreated samples with regard to density and strength. All samples were loaded to failure under diametral and biaxial compression, shear, and three-point bending. RESULTS: Statistical analysis was done on the density and failure stress for all modes of loading. ANOVA did not indicate a significant (p>.05) effect of treatment on the density except for the axial and biaxial specimens (p<.05). ANOVA analysis of failure stress demonstrated no significant differences (p>.05) between cortical bone treated with Biocleanse and untreated specimens under all four types of mechanical loading. Post-experimental power analysis revealed power to be greater than 0.9 for each test. CONCLUSIONS: Sterilization of allograft bone with Biocleanse does not significantly alter the mechanical properties when compared with untreated samples. The effect of this sterilization process on the osteoconductive and osteoinductive properties of allograft bone must be determined.

Aged↗