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Frontiers of Medicine 2019年第6期13卷 723-729页

作者： Bowen Jiang Tej DAzad ethan cottrill Corinna CZygourakis Alex MZhu Neil Crawford Nicholas Theodore Department of Neurosurgery Johns Hopkins School of MedicineBaltimoreMD 21287USA Department of Neurosurgery Stanford University School of MedicineStanfordCA 94305USA Globus Medical Inc.AudubonPA 19403USA

Robotic systems in surgery have developed rapidly. Installations of the da Vinci Surgical System® (Intuitive Surgical, Sunnyvale, CA,, USA), widely used in urological and gynecological procedures, have nearly doubled in the United States from 2010 to 2017. Robotics systems in spine surgery have been adopted more slowly;however, users are enthusiastic about their applications in this subspecialty. Spinal surgery often requires fine manipulation of vital structures that must be accessed via limited surgical corridors and can require repetitive tasks over lengthy periods of time — issues for which robotic assistance is well-positioned to complement human ability. To date, the United States Food and Drug Administration (FDA) has approved 7 robotic systems across 4 companies for use in spinal surgery. The available clinical data evaluating their efficacy have generally demonstrated these systems to be accurate and safe. A critical next step in the broader adoption of surgical robotics in spine surgery is the design and implementation of rigorous comparative studies to interrogate the utility of robotic assistance. Here we discuss current applications of robotics in spine surgery, review robotic systems FDA-approved for use in spine surgery, summarize randomized controlled trials involving robotics in spine surgery, and comment on prospects of robotic-assisted spine surgery.

关键词： robotics spine surgery Mazor ExcelsiusGPS ROSA pedicle screw

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Oxysterols as promising small molecules for bone tissue engineering: Systematic review

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World Journal of Orthopedics 2020年第7期11卷 328-344页

作者： ethan cottrill Julianna Lazzari Zach Pennington Jeff Ehresman Andrew Schilling Naomi Dirckx Nicholas Theodore Daniel Sciubba Timothy Witham Department of Neurosurgery The Johns Hopkins University School of MedicineBaltimoreMD 21287United States

BACKGROUND Bone tissue engineering is an area of continued interest within orthopaedic surgery,as it promises to create implantable bone substitute materials that obviate the need for autologous bone ***,oxysterols–oxygenated derivatives of cholesterol-have been proposed as a novel class of osteoinductive small molecules for bone tissue ***,we present the first systematic review of the in vivo evidence describing the potential therapeutic utility of oxysterols for bone tissue *** To systematically review the available literature examining the effect of oxysterols on in vivo bone *** We conducted a systematic review of the literature following PRISMA *** the PubMed/MEDLINE,Embase,and Web of Science databases,we queried all publications in the English-language literature investigating the effect of oxysterols on in vivo bone *** were screened for eligibility using PICOS criteria and assessed for potential bias using an expanded version of the SYRCLE Risk of Bias assessment *** full-text articles examining the effect of oxysterols on in vivo bone formation were *** data included:Animal species,surgical/defect model,description of therapeutic and control treatments,and method for assessing bone *** outcome was fusion rate for spinal fusion models and percent bone regeneration for critical-sized defect *** were tabulated and described by both surgical/defect model and oxysterol ***,data from all included studies were aggregated to posit the mechanism by which oxysterols may mediate in vivo bone *** Our search identified 267 unique articles,of which 27 underwent full-text *** studies(all preclinical)met our inclusion/exclusion *** the 13 included studies,5 employed spinal fusion models,2 employed critical-sized alveolar defect models,and 6 employed critical-sized calvarial defect *** upon SYRCLE c

关键词： Oxysterol Bone tissue engineering Critical-sized defect Biomaterial Orthopaedic surgery Systematic review

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Investigational growth factors utilized in animal models of spinal fusion: Systematic review

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World Journal of Orthopedics 2019年第4期10卷 176-191页

作者： ethan cottrill A Karim Ahmed Noah Lessing Zachary Pennington Wataru Ishida Alexander Perdomo-Pantoja Sheng-fu Lo Elizabeth Howell Christina Holmes C Rory Goodwin Nicholas Theodore Daniel M Sciubba Timothy F Witham Department of Neurosurgery The Johns Hopkins Hospital Department of Neurosurgery Duke University Medical Center

BACKGROUND Over 400000 Americans annually undergo spinal fusion surgeries, yet up to 40%of these procedures result in pseudoarthrosis even with iliac crest autograft, the current "gold standard" treatment. Tissue engineering has the potential to solve this problem via the creation of bone grafts involving bone-promoting growth factors(e.g., bone morphogenetic protein 2). A broad assessment of experimental growth factors is important to inform future work and clinical potential in this area. To date, however, no study has systematically reviewed the investigational growth factors utilized in preclinical animal models of spinal *** To review all published studies assessing investigational growth factors for spinal fusion in animal models and identify promising agents for *** We conducted a systematic review of the literature using PubMed, Embase,Cochrane Library, and Web of Science databases with searches run on May 29 th,2018. The search query was designed to include all non-human, preclinical animal models of spinal fusion reported in the literature without a timespan limit. Extracted data for each model included surgical approach, level of fusion,animal species and breed, animal age and sex, and any other relevant characteristics. The dosages/sizes of all implant materials, spinal fusion rates,and follow-up time points were recorded. The data were analyzed and the results reported in tables and text. PRISMA guidelines were followed for this systematic *** Twenty-six articles were included in this study, comprising 14 experimental growth factors: AB204(n = 1); angiopoietin 1(n = 1); calcitonin(n = 3);erythropoietin(n = 1); basic fibroblast growth factor(n = 1); growth differentiation factor 5(n = 4), combined insulin-like growth factor 1 +transforming growth factor beta(n = 4); insulin(n = 1); NELL-1(n = 5); noggin(n= 1); P-15(n = 1); peptide B2 A(n = 2); and secreted phosphoprotein 24(n = 1).The fusion rates of the current gold sta

关键词： Spinal fusion Growth factor Pseudoarthrosis Systematic review

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