Use of polyetheretherketone spacer and recombinant human bone morphogenetic protein-2 in the cervical spine: a radiographic analysis
ABSTRACT Results recently reported in the literature have raised some concerns regarding the use of recombinant human bone morphogenetic protein (rhBMP-2) in the cervical spine.
We undertook a radiological and clinical review of cervical fusions performed at our institution with polyetheretherketone (PEEK) interbody cage and rhBMP-2.
Perioperative clinical and radiologic data of all patients who underwent an anterior cervical discectomy and fusion using PEEK and rhBMP-2 for cervical spondylotic radiculopathy or myelopathy were collected.
Images were examined for fusion, heterotopic ossification, end-plate resorption, subsidence, and segmental sagittal alignment.
All patients underwent detailed postoperative radiologic analysis using a computed tomography (CT) scan obtained at least 6 months postoperatively and plain X-rays obtained at regular intervals.
Twenty-two patients had 38 levels fused using PEEK and varying doses of rhBMP-2. No anterior cervical swelling requiring additional procedures or longer than anticipated hospital stays occurred. Pseudoarthrosis, shown as a horizontal radiolucent fissure through the midportion of the PEEK cage on CT, occurred in four patients. Excessive bone growth into the spinal canal or foramina occurred in 26 (68%) patients but did not result in neurologic sequelae. Cystic regions in the core of the PEEK spacer were seen in most patients, with 15 levels (39%) having cysts measuring 3mm or greater. Moderate or severe osteolysis of the end plates occurred in 57% of levels, and this led to subsidence of the construct and loss of some of the segmental sagittal alignment (ie, lordosis) that had been achieved with surgery.
The unlimited supply of PEEK spacers and rhBMP-2 and their ease of use make them attractive platforms to achieve fusion. This study has demonstrated that the fusion process using rhBMP-2 is a dynamic one, with osteolysis dominating the initial phase, leading to end-plate resorption and consequently loss of some of the disc space height and sagittal alignment that was achieved with surgery. There is a high incidence of bone growth beyond the core of the PEEK spacer and cystic regions within the cage. Given our experience, we currently reserve the use of PEEK and rhBMP-2 for use in those patients who are at greatest risk of pseudoarthrosis.
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Conference Paper: A new maximum power point tracking control scheme for wind generation[Show abstract] [Hide abstract]
ABSTRACT: According to the aerodynamical characteristic of the wind turbine, a maximum power point tracking (MPPT) is necessary to get high efficiency for wind power conversion, which means that the rotating speed of wind turbine should be adjusted in the real time to capture maximum wind power. Because of the fast variation of wind speed and the heavy inertia of generator, the MPPT control of wind generation is much challengeable. A new MPPT control scheme has been developed for permanent magnetic (PM) generator driven by a three-phase inverter to generate 350 V direct current power to the DC bus line. The main differences between the method used in the proposed MPPT system and other techniques used in the past are as follows: (1) the tracking step is variable according to the change of wind speed; (2) in order to avoid the dead time effect of the inverter the MPPT control is synchronized to the rotating speed of the generator; (3) a low pass filter is used at the output of the MPPT controller to decrease the fluctuation of the rotating speed reference. The resulting system has high-efficiency, lower-cost and fast, stable tracking speed. The experimental results show that it can track as fast as 0.2Hz variation of wind speed and increases the output wind power as much as 48%. As a result, the efficiency of the generation has been improved evidently.Power System Technology, 2002. Proceedings. PowerCon 2002. International Conference on; 11/2002
Conference Paper: Technical impact of deregulation in Japan [power industry][Show abstract] [Hide abstract]
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