Anatomy of Soft Tissues of the Spinal Canal

Background and Objectives. Important issues regarding the spread of solutions in the epidural space and the anatomy of the site of action of spinal and epidural injections are unresolved. However, the detailed anatomy of the spinal canal has been incompletely determined. We therefore examined the microscopic anatomy of the spinal canal soft tissues, including relationships to the canal walls. Methods. Whole mounts were prepared of decalcified vertebral columns with undisturbed contents from three adult humans. Similar material was prepared from a macaque and baboon immediately on death to control for artifact of tissue change after death. Other tissues examined included nerve root and proximal spinal nerve complex and dorsal epidural fat obtained during surgery. Slides were examined by light microscopy at magnifications of 10-40×. Results. There is no fibrous tissue in the epidural space. The epidural fat is composed of uniform cells enclosed in a fine membrane. The dorsal fat is only attached to the canal wall in the dorsal midline and is often tenuously attached to the dura. The dura is joined to the canal wall only ventrally at the discs. Veins are evident predominantly in the ventral epidural space. Nerve roots are composed of multiple fascicles which disperse as they approach the dorsal root ganglion. An envelope of arachnoid encloses the roots near the site of exit from the dura. Conclusions. These features of the fat explain its semifluid consistency. Lack of substantial attachments to the dura facilitate movement of the dura relative to the canal wall and allow distribution of injected solution. Fibrous barriers are an unlikely explanation for asymmetric epidural anesthesia, but the midline fat could impede solution spread. Details of nerve-root structure and their envelope of pia-arachnoid membrane may be relevant to anesthetic action

Explant Analysis of Total Disc Replacement

Explant analysis of human disc prostheses allow early evaluation of the host response to the prosthesis and the response of the prosthesis from the host. Furthermore, early predictions of failure and wear can be obtained. Thus far, about 2-3% of disc prostheses have been removed. Observed wear patterns are similar to that of appendicular prostheses including abrasions/scratching, burnishing, surface deformation, fatigue, and embedded debris. Chemically the polymeric components have shown little degradation in short-term implantation. In metal on metal prostheses the histologic responses consist of large numbers of metallic particles with occasional macrophages and giant cells. Only rare cases of significant inflammatory response from polymeric debris have been seen

Hybrid A/D converter for 200 deg C operation

A 12 bit A/D converter was designed and developed which will operate at 200 C with .05 linearity, 1/accuracy, 350 WSec conversion time, and only 455 mW power consumption. This product also necessitated the development of a unique three metal system in which aluminum wire bonding is done utilizing aluminum bonding pads, gold wire bonding to all gold areas, and employment of a nickel interface between gold and aluminum connections. This system totally eliminates the formation of a intermetallics at the bonding interface which can lead to bond failure. This product represents an advancement in electronics as it proved the operation of integrated circuits at high temperature, as well as providing information about both the electrical and mechanical reliability of hybrid circuits at 200 C

An Evaluation of The Host Response to An Interspinous Process Device Based on A Series of Spine Explants: Device for Intervertebral Assisted Motion (DIAM®)

Background: The objective of this study was to evaluate the host response to an interspinous process device [Device for Intervertebral Assisted Motion (DIAM®)] based on a series of nine spine explants with a mean post-operative explant time of 35 months. Methods: Explanted periprosthetic tissues were processed for histology and stained with H&E, Wright-Giemsa stain, and Oil Red O. Brightfield and polarized light microscopy were used to evaluate the host response to the device and the resultant particulate debris. The host response was graded per ASTM F981-04. Quantitative histomorphometry was used to characterize particle size, shape, and area per ASTM F1877-05. The presence or absence of bone resorption was also evaluated when bony tissue samples were provided. Results: Periprosthetic tissues demonstrated a non-specific foreign body response composed of macrophages and foreign body giant cells to the DIAM® device in most of the accessions. The foreign body reaction was not the stated reason for explantation in any of the accessions. Per ASTM F981-04, a “very slight” to “mild” to “moderate” chronic inflammatory response was observed to the biomaterials and particulate, and this varied by tissue sample and accession. Particle sizes were consistent amongst the explant patients with mean particle size on the order of several microns. Osteolysis, signs of toxicity, necrosis, an immune response, and/or device related infection were not observed. Conclusions: Cyclic loading of the spine can cause wear in dynamic stabilization systems such as DIAM®. The fabric nature of the DIAM® device’s polyethylene terephthalate jacket coupled with the generation of polymeric particulate debris predisposes the device to a foreign body reaction consisting of macrophages and foreign body giant cells. Although not all patients are aware of symptoms associated with a foreign body reaction to a deeply implanted device, surgeons should be aware of the host response to this device

The Wardle Instability in Interstellar Shocks: I. Nonlinear Dynamical Evolution

The nonlinear evolution of unstable C-type shocks in weakly ionized plasmas is studied by means of time-dependent magnetohydrodynamical simulations. This study is limited to shocks in magnetically dominated plasmas (in which the Alfven speed in the neutrals greatly exceeds the sound speed), and microphysical processes such as ionization and recombination are not followed. Both two-dimensional simulations of planar perpendicular and oblique C-type shocks, and fully three-dimensional simulation of a perpendicular shock are presented.Comment: 20 pages, 7 Postscript figures, LaTeX, accepted by Ap.

HARM: A Numerical Scheme for General Relativistic Magnetohydrodynamics

We describe a conservative, shock-capturing scheme for evolving the equations of general relativistic magnetohydrodynamics. The fluxes are calculated using the Harten, Lax, and van Leer scheme. A variant of constrained transport, proposed earlier by T\'oth, is used to maintain a divergence free magnetic field. Only the covariant form of the metric in a coordinate basis is required to specify the geometry. We describe code performance on a full suite of test problems in both special and general relativity. On smooth flows we show that it converges at second order. We conclude by showing some results from the evolution of a magnetized torus near a rotating black hole.Comment: 38 pages, 18 figures, submitted to Ap

Stellar Winds on the Main-Sequence I: Wind Model

Aims: We develop a method for estimating the properties of stellar winds for low-mass main-sequence stars between masses of 0.4 and 1.1 solar masses at a range of distances from the star. Methods: We use 1D thermal pressure driven hydrodynamic wind models run using the Versatile Advection Code. Using in situ measurements of the solar wind, we produce models for the slow and fast components of the solar wind. We consider two radically different methods for scaling the base temperature of the wind to other stars: in Model A, we assume that wind temperatures are fundamentally linked to coronal temperatures, and in Model B, we assume that the sound speed at the base of the wind is a fixed fraction of the escape velocity. In Paper II of this series, we use observationally constrained rotational evolution models to derive wind mass loss rates. Results: Our model for the solar wind provides an excellent description of the real solar wind far from the solar surface, but is unrealistic within the solar corona. We run a grid of 1200 wind models to derive relations for the wind properties as a function of stellar mass, radius, and wind temperature. Using these results, we explore how wind properties depend on stellar mass and rotation. Conclusions: Based on our two assumptions about the scaling of the wind temperature, we argue that there is still significant uncertainty in how these properties should be determined. Resolution of this uncertainty will probably require both the application of solar wind physics to other stars and detailed observational constraints on the properties of stellar winds. In the final section of this paper, we give step by step instructions for how to apply our results to calculate the stellar wind conditions far from the stellar surface.Comment: 24 pages, 13 figures, 2 tables, Accepted for publication in A&

Instrumented Lumbar Corpectomy and Spinal Reconstruction Comparing rhBMP-2/Compression-Resistant Matrix, rhBMP-2/Absorbable Collagen Sponge/Ceramic Granules Mixture, and Autograft in Two Different Devices: A Study in Sheep

Study Design. Fusion success with rhBMP-2 and autograft in titanium or PEEK corpectomy devices was evaluated in a sheep lumbar corpectomy model. The 6 treatment groups included titanium mesh or PEEK corpectomy devices filled with rhBMP-2 on a compression-resistant matrix (CRM) carrier; rhBMP-2 in a morselized absorbable collagen sponge (ACS) carrier combined with resorbable ceramic granules; and autograft. Objective. The aim of this study was to determine fusion rates associated with 2 different preparations of rhBMP-2 as well as autograft in an instrumented ovine lumbar corpectomy model 6 months postoperatively. Summary of Background Data. Vertebral reconstruction with corpectomy devices requires bone graft. Bone graft substitutes have the potential to avoid a second operation, donor site pain, and attendant morbidity associated with autograft. Methods. Twenty-four sheep in 6 treatment groups underwent lumbar corpectomy via a retroperitoneal trans-psoas approach. Spines were reconstructed with autograft, rhBMP-2 on a CRM, or rhBMP-2 on an ACS mixed with ceramic granules. Grafting materials were placed in either a titanium mesh or PEEK conduit in spines with internal fixation. Computed tomographic (CT) scans were evaluated for fusion. Undecalcified histology was used to evaluate for fusion as well as the amount and extent of graft incorporation and graft resorption. Results. Regardless of corpectomy device used, rhBMP-2/CRM or rhBMP-2/ACS with MASTERGRAFT resulted in a 100% fusion rate. The autograft group had a lower (75%) radiographic fusion rate. Using either preparation of rhBMP-2 resulted in the length of the defect filling with solid bone. Autograft fragments and ceramic granules were incorporated into the fusion masses with much of the ceramic granules being resorbed by 6 months. Conclusion. Both of the rhBMP-2 formulations have the potential to effect bony fusion and vertebral reconstruction within the corpectomy devices