bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conventional versus tubular microdiscectomy for lumbar disc herniation: A prospective randomized study
Authors: Sonawane Dhiraj V , Chobing Habung , Kolur Shivaprasad S , Chandanwale Ajay , Jawale Sagar A , Ansari Naved A F A , Pawar Eknath 
Published: February 2024

Abstract

Background:
Microdiscectomy is a commonly performed surgical technique used to treat lumbar disc prolapse. A minimally invasive alternative called tubular discectomy is hypothesized to cause less tissue damage and result in a faster recovery compared to conventional discectomy. Previous studies have found similar pain resolution outcomes between two techniques, but they were underpowered and lacked data on differences in recovery time. Our study aims to compare functional outcomes, and assess differences in recovery time and perioperative complications between the two procedures.

Materials and Methods:
This prospective randomized study included 63 patients, divided into two groups. The preoperative evaluation was done by clinical examination and documenting Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. Intra- and postoperative complications were also noted. Postoperative follow-up assessment was done at regular intervals up to 2 years.

Results:
Both groups showed a significant decrease in ODI, VAS leg and back scores following surgery, which continued to decline throughout the follow-up period. However, there was no significant difference in outcomes between the two treatment groups at each postoperative follow-up. There were also no significant differences in blood loss or intra- and postoperative complications. Patients who underwent tubular microdiscectomy had a significantly shorter hospital stay compared to conventional microdiscectomy.

Conclusion:
Both conventional and tubular microdiscectomy are effective means of treating disc herniation. While patients who underwent tubular microdiscectomy had a shorter hospital stay, the modest clinical benefits do not necessarily warrant the transition to a minimally invasive approach given the learning curve associated with the technique.
Structured spine fellowship programs in India: Current trends and perceptions
Authors: Basu Saumyajit , Banta Aditya , Gohil Kushal 
Published: February 2024

Abstract

Introduction:
The present study aimed to assess the quality of training provided during Structured Spine Fellowships (SSF) and explore the expectations of candidates. The study sought to investigate the utility of SSFs and emphasized the importance of evaluating the fellowship center’s curriculum as well as trainees’ surgical and theoretical competency.

Materials and Methods:
A retrospective descriptive study was conducted on 100 spine surgeons, 66 from Fellow of the National Board and 34 from the Association of Spine Surgeons of India, using a questionnaire. The survey had three parts, assessing pre-fellowship demographics, feedback on the fellowship conducted, and post-fellowship settlement.

Results:
The hands-on experience was the most important factor affecting the choice of center, and the average work time was 14 h per day. Nearly 50% of fellows were doing independent cervical dorsal and lumbar surgeries by the end of the fellowship. Academics were mainly in the form of regular case presentations for 55% of fellows, and the average number of publications done was 1.6. Most fellows settled near their native city, practiced exclusive spine surgery, and did a mean of 2.6 additional fellowships.

Conclusion:
This study provides a comprehensive overview of the structured spine fellowship programs in India. The findings highlight the need for standardization and quality control measures in these programs to ensure that they provide a comprehensive and uniform education to the fellows. The study also underscores the importance of ongoing evaluation and assessment to improve the effectiveness of these programs in producing skilled and competent spine surgeons.
Does platelet-rich plasma enhance fusion in transforaminal lumbar interbody fusion? A prospective clinico-radiological comparative study
Authors: Sudhir G , Vignesh Jayabalan S , Prasath Gokul , Ravi Veeraraghavan Raghav , Kailash Karthik 
Published: February 2024

Abstract

Background:
Several animal studies have shown that platelet-rich plasma (PRP) is effective in enhancing bone fusion. However, the role and efficacy of PRP in spinal fusion surgery remain uncertain. The objective was to evaluate the efficacy of PRP in bone fusion and to compare the clinical and radiological outcomes of transforaminal lumbar interbody fusion (TLIF) with and without PRP.

Materials and Methods:
This prospective study was done on 50 patients who underwent TLIF surgery for various spinal pathologies. Patients were divided into the control group (underwent TLIF with interbody cage and local bone grafts alone) and the study group (underwent TLIF with interbody cage, local bone grafts, and PRP). Functional outcome was evaluated using visual analog score (VAS) and Oswestry disability index (ODI). Radiological outcome was assessed by Bridwell’s grading system for fusion on computed tomography scan at the end of 2 years.

Results:
The average bone fusion rate was significantly higher in the PRP group compared to the control group; however, the average duration of fusion was not statistically significant. There was no difference in VAS and ODI at 1 and 2 years. There was also no significant difference in lower back pain, leg pain, and numbness in both groups at the end of 1 year.

Conclusion:
Although there is no statistically significant difference in functional outcome between both groups, local application of PRP along with autologous bone grafts increases bone fusion rates with good clinical and radiological outcomes.
Stab injury to the spine with retained knife blade and aortic injury: A case report and review of the literature
Authors: Naicker Denver , Pswaryi Rudo 
Published: February 2024

Abstract
Nonmissile penetrating spine injuries are relatively common in developing countries. Associated injuries are most commonly pneumothoraxes or bowel injuries and rarely vascular injuries. Penetrating aortic injuries are life-threatening and require prompt workup and management. A 51-year-old male patient presented after being stabbed in the back with a blade lodged at vertebral body T10/T1l. The blade tip was in the lumen of the descending thoracic aorta. This patient was successfully managed with thoracotomy and aortic repair, followed by the removal of the blade via an open laminectomy. The patient remained neurologically intact with no complicating features. Patients with penetrating spine injuries and retained blades need adequate workup to exclude other injuries prior to the removal of the blade. A multidisciplinary approach is important in the management of these patients to prevent devastating outcomes.
Concomitant spinal and non-spinal osteoarticular infections
Authors: Fukushi Ryunosuke , Kawaguchi Satoshi , Horigome Keiko , Yajima Hideki , Yamashita Toshihiko 
Published: February 2024

Abstract

Background:
Treatment of pyogenic spondylodiscitis or septic arthritis can be complicated with a variety of concomitant infectious processes. No study has focused on concomitant osteoarticular infections.

Materials and Methods:
Between 2015 and 2019, patients over 18 years old, who were diagnosed and treated for spinal infections (SIs) or non-spinal osteoarticular infections, were included. There were six patients with concomitant spinal and non-spinal osteoarticular infections (concomitant infection [CI] group), 30 patients with SI alone (SI group), and 18 patients with articular infection (AI) alone (AI group). The data gained from the patients in the CI group were compared those in the SI group and the AI group.

Results:
Factors contributing to statistical significance included past or present history of cancer (100% in the CI group, 27% in the SI group, and 33% in the AI group), C-reactive protein (CRP) levels (27.4 mg/dL in the CI group, 13.4 mg/dL in the SI group, and 13.8 mg/dL in the AI Group), albumin levels (2.4 g/dL in the CI group and 2.9 in both the SI group and the AI group), detection of Group B Streptococcus (GBS) (50% in the CI group, 3.3% in the SI group and 5.6% in the AI group), and duration of intravenous antibiotic therapy (131 days in the CI group, 67 days in the SI group and 29 days in the AI group).

Conclusions:
Patients with concomitant spinal and non-spinal osteoarticular infections were more likely to present with a past and present history of cancer, severe hypoalbuminemia, higher levels of CRP and GBS bacteremia.
Dorsal epidural migration of lumbar disc herniation at L3-L4 level treated by minimally invasive microtubular decompression and fixation: A case report
Authors: Mittal Samarth , Bharti Bhupendra P , Verma Rajesh , Girdhar Puneet 
Published: February 2024

Abstract
Lumbar disc herniation with dorsal epidural migration is a rare clinical condition that can present with severe neurological deficit and cauda equina syndrome. Diagnosis poses a challenge as it mimics other dorsal epidural pathologies like tumors, cysts, and abscesses. Timely diagnosis and early surgical intervention with wide decompression can improve the neurological outcome. Minimally invasive technique has the advantage of minimal muscle damage, early rehabilitation, and equal clinical outcomes to those of standard laminectomy. In this report, we describe a case of a 63-year-old male with lumbar disc herniation at L3-L4 level with foraminal extension and dorsal epidural migration with neurological deficit managed by minimally invasive microtubular decompression and spinal stabilization.
Intradural lumbar disc herniation at the L3–L4 level: A case report and literature review
Authors: Nguyen Vinh-Lac , Le Trong-Hieu , Tran Duc-Hoang , Nguyen Thanh-Minh 
Published: February 2024

Abstract
Only 0.26% of all disc herniations are caused by intradural disc herniation (IDH), making it a rare pathology. We present the case of a 44-year-old man who suffered from right radicular low back pain and motor impairments. At the level of L3–L4, magnetic resonance imaging (MRI) revealed an intradural, extra-axial spinal mass. This individual had several specific MRI imaging characteristics. Laminectomy, durotomy, and transforaminal lumbar interbody fusion surgery was performed, and the disc was completely removed. At the 6-month follow-up, the patient showed full recovery. The diagnosis of IDH is very challenging and every spine surgeon must be aware. The best treatment for this pathology is surgical intervention.
Comparative evaluation of antifungal activity of Sodium Hypochlorite, Calcium Hypochlorite and modified Salt Solution associated with passive ultrasonic irrigation against Candida albicans - An In-Vitro study
Authors: Thomas Helen , Nirupama D. N. , Nainan Mohan Thomas , Naveen D. N. , Ranjini C. Y. , Vijay R. 
Published: February 2024

Abstract

Aim:
The study evaluated the antifungal activity of sodium hypochlorite (NaOCl), calcium hypochlorite (Ca(OCl)2), and modified salt solution (MSS) assisted with passive ultrasonic irrigation against Candida albicans.

Materials and Methods:
One hundred and thirty-six single-rooted premolars were decoronated and enlarged up to a file #45, autoclaved, inoculated with C. albicans, and incubated for 72 h. The samples were randomly distributed into eight groups (n = 17) according to the protocol for decontamination G1: No treatment, G2: Distilled water (DW), G3: 2.5% NaOCl, G4: 2.5% NaOCl + ultrasonic activation (US), G5: 2.5% Ca(OCl)2, G6: 2.5% Ca(OCl)2 + US, G7: MSS, G8: MSS + US. Microbiological testing (Colony forming Unit [CFU] counting) was performed before and after the treatment.

Statistical Analysis:
Data were subjected to the one-way analysis of variance followed by the Tukey’s post hoc test (P < 0.05).

Results and Conclusion:
Groups 1 and 2 showed the highest mean contamination (5.41 and 4.31 log10 CFU/mL, respectively), which was statistically different from all the other groups (P < 0.001). G4 showed the lowest mean contamination (0.24 log10 CFU/mL) with statistically significant value (P < 0.001). 2.5% NaOCl with ultrasonic activation can aid in significant fungal reduction. Ultrasonic activation of 2.5% NaOCl, 2.5% Ca(OCl)2, and MSS was also found to have improved antifungal activity against C. albicans.
Comparison of bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia: A systematic review and meta-analysis
Authors: Borouziniat Alireza , Majidinia Sara , Shirazi Alireza Sarraf , Kahnemuee Fatemeh 
Published: February 2024

Abstract
The aim of this study was to systematically compare the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia. The PubMed, ISI (all), and Scopus databases were searched for the selected keywords up to November 1, 2021, without date or language restrictions. In vitro studies comparing the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia were eligible for inclusion in the study. The selected articles were divided into four groups based on the type of resin cement and the storage time. Statistical analysis was performed using the Biostat Comprehensive Meta-Analysis Software version 2 (α = 0.05). The effect of conventional cement ( Glass Ionomer (GI), Resin Modified Glass Ionomer (RMGI) and zinc phosphate) was analyzed using descriptive analysis. The initial search yielded 376 articles, of which 26 were selected after a methodological assessment. Two reviewers independently extracted data and assessed the risk of bias. The results showed that the immediate or delay bond strength of the self-adhesive resin cement to zirconia has no significant difference with the bond strength of self-etch resin cement to zirconia. The immediate and delay bond strength of total-etch cement-zirconia was significantly lower than that of self-adhesive cement-zirconia (P = 0.00). A descriptive analysis of the selected articles showed that the bond strength of self-adhesive resin cement to zirconia was significantly higher than total-etch cement. The results of the meta-analysis showed that both self-adhesive and self-etch resin cement (if applied according to their manufacturer’s instruction) are suitable for bonding to zirconia.
Spectrophotometric evaluation of color stability of composite resin after exposure to cold drinks: An in vitro study
Authors: Fathima J. Noor , Hashir M. Mohamed Jubair , Padmanabhan Kadambari 
Published: February 2024

Abstract

Objectives:
The aim of this study was to evaluate the color stability of two composite resins after exposure to beverages such as Cola, Pepsi, Red Bull, and distilled water after 15 days.

Materials and Methods:
The color stability of a microhybrid and nanohybrid composite was evaluated after storage in distilled water, Coca-Cola, Pepsi, and Red Bull for 15 days. Color measurement was done using a reflectance spectrophotometer based on the CIE L*a*b* color scale.

Results:
All tested resin composites showed color change after a period of 15 days. One-way analysis of variance and Tukey post hoc were done to assess the significance of color change within the group and an independent t-test was done to assess the change between micro and nanohybrid composite. Among the resin composites studied, microhybrid composite was found to be more color stable. The microhybrid and nanohybrid composite discolored most in Coca-Cola and Pepsi. In both groups, distilled water showed very less color change.

Conclusion:
Every endeavor should be undertaken to minimize the potential for discoloration in composite restorations by employing meticulous polishing techniques and also to use newer composite material with submicron particles. Furthermore, it is imperative to educate patients about the likelihood of the restoration being susceptible to staining from various beverages.
Modified single-step apexification and strengthening of thin dentinal walls with Biodentine
Authors: Thakur Vivek 
Published: February 2024

Abstract
Apexification is a technique used to create a mineralized barrier in a root having an open apex or to continue the apical growth of a root that is still not fully developed in teeth with necrotic pulps. Biodentine is a versatile material which can help in achieving apical closure as well as reinforcement of thin dentinal walls, thus improving the overall prognosis and preserving the natural dentition. In the present case, the radiographic evaluation showed thinner dentinal walls and an open apex with periapical radiolucency in relation to the upper right central incisor. The large open root apex and thin dentin walls of immature permanent teeth render them challenging to treat with root canal therapy. This case report describes a modified single-step apexification procedure and strengthening of the dentinal walls of the root canal using Biodentine.
Comparative evaluation of shear bond strength and modes of failure of five different reinforced glass ionomer restorative cements to TheraCal LC: An in vitro study
Authors: Umale Kalyani Gajanan , Gade Vandana Jaykumar , Raut Ambar W. 
Published: February 2024

Abstract

Aim:
The aim of the study is to evaluate and compare the shear bond strength (SBS) and modes of failure of different reinforced glass ionomer cement restorative materials such as GC IX, GC Gold Label 2 LC, Amalgomer CR, Equia Forte, and Secure Core Z to TheraCal LC.

Methodology:
A total of 50 acrylic blocks, each containing a cylindrical hole in the center were prepared from self-cure acrylic resin and randomly divided into five groups and restored, namely Group A - TheraCal LC + GC Fuji IX, Group B - TheraCal LC + GC Gold Label 2 LC, Group C - TheraCal LC + Amalgomer CR, Group D - TheraCal LC + Equia Forte, and Group E - TheraCal LC + Secure Core Z. All the specimens were stored in artificial saliva at 37°C for 24 h before testing. The statistical tests used for the analysis of the result were: one-way ANOVA, Tukey multiple comparison test, and the Chi-squared test, and P < 0.05 is considered as the level of significance.

Results:
Equia Forte showed the highest SBS, while GC type IX showed the lowest SBS with TheraCal LC.

Conclusion:
Equia Forte can be the restorative material of choice when TheraCal LC is used as a base materials for better clinical efficacy.
An unusual case of maxillary first molar with seven canals and the successful surgical recovery of a separated instrument
Authors: Kadoo Shubhangi , Patni Pallav Mahesh , Jain Pradeep , Agrawal Nikit , Raghuwanshi Swadhin , Pandey Sanket Hans 
Published: February 2024

Abstract
This case report highlights the intricate anatomy of root canals and the challenges they pose for clinicians. A 26-year-old female patient presented to the department with a chief complaint of pain in her left upper back tooth region. After thorough clinical and radiographical examinations, the diagnosis of pulpal necrosis with symptomatic apical periodontitis in the maxillary left first molar was confirmed. An intraoperative cone-beam computed tomography was performed. The axial imaging unveiled that there were, two distal (DB1 and DB2) canals, two palatal (P1 and P2) canals, and three mesiobuccal (MB1, MB2, and MB3) canals. The appearance of a convoluted root canal configuration serves to highlight the inherent complexity that clinicians may encounter during endodontic procedures. However, when this complexity is further compounded by the incident of separation of root canal instruments, the challenges faced by clinicians become significantly more demanding. It exemplifies the increased difficulty posed by the combination of tortuous root canal morphology and the additional complication of instrument separation, highlighting the importance of careful management and precise techniques in such scenarios and the significance of modern adjuncts, into the diagnostic process and magnification in the surgical and endodontic therapy.
Comparative evaluation of the effect of ultrasonic and rotary agitation of herbal irrigating solutions on smear layer: A SEM study
Authors: Chavate Prajhna R. , Ponnappa K. C. , Nanjappa A. Salin 
Published: February 2024

Abstract

Context:
Instrumentation and irrigation balance helps in effective removal of endodontic microbes housing inside the smear layer.

Aim:
This study aimed to (1) evaluate whether activation of the irrigating solutions with two different systems during the final irrigation step can lead to smear layer formation in the middle and apical third of the root canal and (2) evaluate and compare the smear layer removal ability of the aqueous extracts of Emblica officinalis and Morinda citrifolia.

Materials and Methods:
A total of 72 single-rooted teeth were prepared up to F4 ProTaper. The specimens were assigned into eight groups of nine teeth each, according to the final irrigant and activation techniques. Further, the teeth were evaluated under SEM for endodontic smear layer at the middle and apical third.

Statistical Analysis:
Inferential statistics included Pearson’s Chi-square. Level of significance was set at 0.05 at 95% confidence level.

Results:
Ultrasonic activation system showed significant (P = 0.000) amount of smear layer compared to XP-Endo Finisher file. A significant difference (P = 0.00) in the smear layer removal was observed when 6% M. citrifolia was activated with XP-Endo Finisher file both in the middle and apical third.

Conclusion:
Within the limitations of this in vitro study, it can be concluded that smear layer formation was noted with ultrasonic and XP-Endo Finisher file when saline was used as an irrigant. 6% M. citrifolia when activated with XP-Endo Finisher file showed best results among all other experimental groups.
Investigating the accuracy of Johnson’s rule in estimating fetal weight
Authors: Alidoosti Fariba , Valiani Mahboubeh , Pirhadi Masoume 
Published: February 2024

BACKGROUND:
Birth weight has a significant impact on perinatal mortality. Therefore, the estimation of fetal weight greatly influences the policies necessary for care during and after delivery. We aimed to investigate Johnson’s rule in estimating fetal weight.

MATERIALS AND METHOD:
This study was a single-group longitudinal study that was conducted in 6 months from October 2021 to April 2022 on 150 pregnant women in Isfahan-Iran. The sampling method was accessible. Inclusion criteria include being term, singleton, without abnormality, intact membranes, cephalic presentation, and exclusion criteria include diagnosed polyhydramnios or oligohydramnios and mother’s abdominal or pelvic known masses. After completing the informed consent, fetal weight was estimated by Johnson’s rule and was compared with the birth weight. Descriptive and analytical statistics (mean-standard deviation (SD), number-percentage, t-paired, and Spearman’s correlation coefficient) were used to achieve the objectives of the study. The receiver operating characteristic (ROC) curve was also used to determine the sensitivity, specificity, and positive and negative predictive value of Johnson’s law.

RESULT:
The mean (SD) birth weight was 3032.88 ± 481.11 g and the mean (SD) estimated fetal weight (EFW) by the clinical method was 3152.15 ± 391.95 g. There was a significant difference between the averages (P < 0.001). The percentage error of EFW showed a significant negative correlation (r = -0.286; P < 0.05) with gestational age (GA) and a significant positive correlation (r = 0.263; P < 0.05) with the fetal head station. The sensitivity and specificity of EFW with Johnson’s rule, in normal fetal birth weight, were higher than in low birth weight fetal. The accuracy of EFW with ± 10% of the actual weight was higher in average for gestational age (AGA) (84.3%) and high-for-gestational-age (LGA) (70%) than in low-for-gestational-age (SGA) (4%). The EFW mean percentage error in SGA was higher than in the other two weight groups. This method, especially for AGA and LGA fetuses, can be a suitable alternative to other weight estimation methods.

CONCLUSION:
Clinical estimation of weight via Johnson’s rule due to availability and no cost can be a suitable method for managing childbirth based on fetal weight.