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At least 19 records

Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population

Introduction: To evaluate the effectiveness of percutaneous image-guided vertebral body stenting (VBS) at restoring vertebral height in acute, stable, traumatic thoracolumbar fractures in a young, non-osteoporotic population. Materials and Methods: A single-centre retrospective review of all traumatic non-osteoporotic fractures treated with VBS between 2010 and 2017 was performed. Inclusion criteria included patients with recent (< 10 days), symptomatic and stable thoracolumbar compression fractures. Patients with low-energy fractures, osteoporosis and age > 60/50 years (male/female) were excluded. Primary outcomes included: correction of vertebral height, correction of kyphosis angle and Beck Index on reconstructed pre- and post-procedural CBCT images. Secondary outcomes included intra-procedural stent recoil, complications, cement leakage and factors predicting height restoration. Results: Thirty-nine patients (26 men, 13 women; mean age 33.6 years, range 15–57 years) underwent VBS 5 days post-trauma on average (range 1–10), for stable compression fractures located between T5 and L5. Mean vertebral height gain, vertebral kyphosis angle correction and Beck index improvement were 3.8 mm (95% CI 3.36–4.50; P(> 3 mm) = 99.9%), 4.3° (95% CI 3.50–5.20; P(> 3°) = 99.9%) and 0.07 [95% CI 0.053–0.11], respectively (all statistically significant). Technical success was 92%, with 3 “major” stent recoils resulting in loss of vertebral height correction. No symptomatic complications were observed. No predictive factors for procedural success were identified. Conclusion: VBS can significantly restore vertebral height in young patients with traumatic vertebral compression fractures.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Risk Prediction of New Adjacent Vertebral Fractures After PVP for Patients with Vertebral Compression Fractures: Development of a Prediction Model

PurposeWe aim to determine the predictors of new adjacent vertebral fractures (AVCFs) after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fractures (OVCFs) and to construct a risk prediction score to estimate a 2-year new AVCF risk-by-risk factor condition.Materials and MethodsPatients with OVCFs who underwent their first PVP between December 2006 and December 2013 at Hospital A (training cohort) and Hospital B (validation cohort) were included in this study. In training cohort, we assessed the independent risk predictors and developed the probability of new adjacent OVCFs (PNAV) score system using the Cox proportional hazard regression analysis. The accuracy of this system was then validated in both training and validation cohorts by concordance (c) statistic.Results421 patients (training cohort: n = 256; validation cohort: n = 165) were included in this study. In training cohort, new AVCFs after the first PVP treatment occurred in 33 (12.9%) patients. The independent risk factors were intradiscal cement leakage and preexisting old vertebral compression fracture(s). The estimated 2-year absolute risk of new AVCFs ranged from less than 4% in patients with neither independent risk factors to more than 45% in individuals with both factors.ConclusionsThe PNAV score is an objective and easy approach to predict the risk of new AVCFs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Effects of Single-Dose Versus Hypofractionated Focused Radiation on Vertebral Body Structure and Biomechanical Integrity: Development of a Rabbit Radiation-Induced Vertebral Compression Fracture Model

Vertebral compression fracture is a common complication of spinal stereotactic body radiation therapy. Development of an in vivo model is crucial to fully understand how focal radiation treatment affects vertebral integrity and biology at various dose fractionation regimens. We present a clinically relevant animal model to analyze the effects of localized, high-dose radiation on vertebral microstructure and mechanical integrity. Using this model, we test the hypothesis that fractionation of radiation dosing can reduce focused radiation therapy's harmful effects on the spine.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Effects of red imported fire ant ( Solenopsis invicta ) control on carrion use by vertebrate scavengers

Carrion is an important resource, and competition for carrion by microbial, invertebrate, and vertebrate scavenging communities is great. In particular, carrion is important to facultative and obligate vertebrate scavengers globally, and these species provide an irreplaceable ecological service by efficiently removing carcasses, which potentially harbor pathogens, from the environment. Although vertebrates efficiently acquire carcasses, they compete intensively with invertebrate and microbial communities, especially during warmer months when invertebrate and microbial activity peaks. The presence of invasive invertebrates may further exacerbate competition among scavenging groups; however, little is known about how invasive invertebrates can influence invertebrate scavenger dynamics and ultimately competition with vertebrate scavengers. The red imported fire ant (Solenopsis invicta; RIFA) is an invasive species of particular interest in North America, as it is a dominant predator and decomposer throughout much their range. We hypothesized that in areas where abundant, RIFA can outcompete vertebrates for carrion resources, altering nutrient cycling and food web dynamics. We tested this hypothesis by experimentally excluding RIFA from rabbit carcasses and found strong seasonal effects in our data; however, surprisingly, we found no effect of RIFA control on vertebrate scavenging efficiency, rates of carcass detection, carcass persistence, or the richness of local scavengers. Rather, we observed a highly efficient vertebrate scavenging community that assimilated 87.4% of carcasses during our study. Furthermore, this high rate of vertebrate scavenging efficiency was maintained in both control (93.0%) and RIFA treatment (81.8%) sites, suggesting presence of abundant RIFA populations did not limit vertebrate acquisition of carrion. Future research should focus on the interactions of RIFA with the remaining invertebrate scavenging community to further investigate whether RIFA impact the assimilation of carrion resources within invertebrate communities.

59 BASIC BIOLOGICAL SCIENCES↗

The orphan G protein-coupled receptor 25 (GPR25) is activated by Apelin and Apela in non-mammalian vertebrates

Highlights: • The orphan receptor GPR25 was cloned from zebrafish, pigeons and spotted gars. • GPR25 is activated by Apelin and Apela in non-mammalian vertebrates. • Like Apelin receptor, GPR25 is coupled to Gi-cAMP signaling pathway. • GPR25 mRNA is widely expressed in zebrafish/spotted gar/human tissues. G protein-coupled receptor 25 (GPR25) is an orphan G protein-coupled receptor in vertebrates, that has been implicated to be associated with autoimmune diseases and regulate blood pressure in humans. However, the endogenous ligand of GPR25 remains unknown in vertebrates. Here, we reported that in non-mammalian vertebrates (zebrafish, spotted gars, and pigeons), GPR25 could be activated by Apelin and Apela peptides, which are also the two endogenous ligands of vertebrate Apelin receptor (APLNR). Using the pGL3-CRE-luciferase reporter assay and confocal microscopy, we first demonstrated that like APLNR, zebrafish GPR25 expressing in HEK293 cells could be effectively activated by zebrafish Apelin and Apela peptides, leading to the inhibition of forskolin-stimulated cAMP production and receptor internalization. Like zebrafish GPR25, pigeon and spotted gar GPR25 could also be activated by Apelin and Apela, and their activation could inhibit forskolin-induced cAMP accumulation. Interestingly, unlike zebrafish (/spotted gar/pigeon) GPR25, human GPR25 could not be activated by Apelin and Apela under the same experimental conditions. RNA-seq analysis further revealed that GPR25 is expressed in a variety of tissues, including the testes and intestine of zebrafish/spotted gars/humans, implying the potential roles of GPR25 signaling in many physiological processes in vertebrates. Taken together, our data not only provides the first proof that the orphan receptor GPR25 possesses two potential ligands ‘Apelin and Apela’ and its activation decreases intracellular cAMP levels in non-mammalian vertebrates, but also facilitates to unravel the physiological roles of GPR25 signaling in vertebrates.

60 APPLIED LIFE SCIENCES↗

A Unified Anatomy Ontology of the Vertebrate Skeletal System

The skeleton is of fundamental importance in research in comparative vertebrate morphology, paleontology, biomechanics, developmental biology, and systematics. Motivated by research questions that require computational access to and comparative reasoning across the diverse skeletal phenotypes of vertebrates, we developed a module of anatomical concepts for the skeletal system, the Vertebrate Skeletal Anatomy Ontology (VSAO), to accommodate and unify the existing skeletal terminologies for the species-specific (mouse, the frog Xenopus, zebrafish) and multispecies (teleost, amphibian) vertebrate anatomy ontologies. Previous differences between these terminologies prevented even simple queries across databases pertaining to vertebrate morphology. This module of upper-level and specific skeletal terms currently includes 223 defined terms and 179 synonyms that integrate skeletal cells, tissues, biological processes, organs (skeletal elements such as bones and cartilages), and subdivisions of the skeletal system. The VSAO is designed to integrate with other ontologies, including the Common Anatomy Reference Ontology (CARO), Gene Ontology (GO), Uberon, and Cell Ontology (CL), and it is freely available to the community to be updated with additional terms required for research. Its structure accommodates anatomical variation among vertebrate species in development, structure, and composition. Annotation of diverse vertebrate phenotypes with this ontology will enable novel inquiries across the full spectrum of phenotypic diversity

59 BASIC BIOLOGICAL SCIENCES↗

Abiotic and biotic factors modulate carrion fate and vertebrate scavenging communities

Carrion is a valuable nutrient resource used by a diversity of vertebrates across the globe. However, vertebrate scavenging ecology remains an understudied area of science, especially in regards to how biotic and abiotic factors influence scavenging community composition. Here we elucidate how fundamental biotic and abiotic factors interact to modulate the efficiency and composition of vertebrate scavengers by investigating scavenging dynamics across a large gradient in carcass sizes and habitat types representative of many temperate ecosystems, as well as between two seasons reflecting differences in invertebrate activity. We found carcass size and season influenced carcass fate and persistence, as well as the richness and composition of vertebrate scavenger communities utilizing carrion resources. Species richness, which increased as carcass size increased and was higher during the cool season, had a significant effect on carcass persistence. In addition, habitat type influenced carcass detection times by vertebrates, and we observed relatively distinct scavenging communities associated with carcasses of differing sizes. This research highlights a pervasive limitation to the interpretation of results of previous studies as research failing to incorporate carcass size and habitat type could result in the over or underrepresentation of vertebrate scavengers in food web dynamics.

54 ENVIRONMENTAL SCIENCES↗

Vertebrate and invertebrate competition for carrion in human‐impacted environments depends on abiotic factors

Abstract Human altered landscapes have caused declines in the diversity of wildlife where behaviorally plastic species (i.e., mesocarnivores and invasive species) tend to monopolize these areas and consume predictable and readily accessible food resources, such as human food waste and carrion. Increased consumption of carrion by vertebrates and invasive invertebrate species can alter population dynamics of native necrophagous insects relying on these resources. We tested the hypothesis that vertebrate scavengers and invasive species reduce blow fly (1) ability to use carrion and (2) reproduction in human‐impacted environments in central Texas, USA, with season, habitat (field and wooded landscapes), and carrion type (species of carrion and coat color) acting synergistically. Vertebrate scavengers in this habitat, of which 75% of the documented species were mesocarnivores and obligate scavengers, consumed 100% of carrion during the winter and 62% during summer despite having low species richness (2–5 species). Of the remaining carcasses available for arthropod activity during summer, the invasive red imported fire ant, Solenopsis invicta (Hymenoptera: Formicidae), monopolized 34%, and blow flies (e.g., Lucilia eximia and Chrysomya rufifacies [Diptera: Calliphoridae]) were only able to colonize 25%. Approximately 90% of carrion that was utilized by blow flies was co‐colonized by fire ants, and subsequent production of adult blow flies experienced up to a ninefold reduction in production compared with carcasses that were not scavenged by vertebrates or fire ants. Our results demonstrate oviposition resources used by blow flies in environments altered by human activity are reduced significantly by vertebrate scavengers and an invasive ant species. Future research should determine whether competitive interactions between vertebrate and invasive ant competitors for access to carrion resources have population‐level impacts to blow flies in human‐mediated ecosystems, or whether blow flies are able to shift to other resources to maintain sustainable populations and continue providing ecosystem services, such as pollination.

54 ENVIRONMENTAL SCIENCES↗

Percutaneous Vertebroplasty is no Risk Factor for New Vertebral Fractures and Protects Against Further Height Loss (VERTOS IV)

Background: Percutaneous vertebroplasty (PV) is an alternative option to treat pain after an osteoporotic vertebral compression fracture (OVCF). Controversy exists as to whether PV increases the risk of new OVCFs or prevents further vertebral height loss in treated levels. We assessed both during 1-year follow-up in patients with acute OVCF randomised to PV or a sham procedure. Methods: VERTOS IV is a prospective, multicentre, randomised controlled trial comparing PV with sham therapy in 180 patients. New OVCFs and further vertebral height loss were assessed at 3, 6, and 12 months. Results: After a median follow-up of 12 months (interquartile range (IQR) = 12–12) 31 new fractures were reported in 15 patients from the PV group and 28 new fractures in 19 patients from the sham group. The occurrence of new vertebral fractures did not significantly differ between the groups (χ{sup 2}(1) = 0.83, p = 0.36, OR = .71, 95%CI = 0.33–1.50). There was no higher fracture risk of adjacent versus distant vertebrae. After sham procedure, further height loss of treated vertebrae occurred more frequently (7 patients (8%) in the PV group and 39 (45%) in the sham group (χ{sup 2}(1) = 28.85, p < 0.001, OR = 9.84, 95%CI = 4.08–23.73)) and was more severe (p < .001) than after PV. Conclusions: The risk of further vertebral height loss is significantly lower after PV compared to a sham intervention, i.e. PV protects against progressive vertebral height loss. In addition, PV does not increase the risk of new adjacent and distant OVCFs. Level of Evidence: Level 1a, therapeutic study. ClinicalTrials.gov number, NCT01200277.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

High-Dose Hypofractionated Radiation Therapy for Noncompressive Vertebral Metastases in Combination With Zoledronate: A Phase 1 Study

Introduction: Hypofractionated stereotactic radiation therapy (HSRT) for vertebral metastases gives good results in terms of local control but increases the risk of fracture in the treated volume. Preclinical and clinical studies have shown that zoledronate not only reduces the risk of fracture and stimulates osteoclastic remodeling but also increases the immune response and radiosensitivity. This study aimed to evaluate the tolerability and effectiveness of zoledronate in association with radiation therapy. Patients and Methods: We conducted a multicenter phase 1 study that combined HSRT (3 × 9 Gy) and zoledronate in patients with vertebral metastasis ( (NCT01219790)). The principal objective was the absence of spinal cord adverse reactions at 1 year. The secondary objectives were acute tolerability, the presentation of a bone event, local tumor control, pain control, progression-free survival, and overall survival. Results: Thirty patients (25 male, 5 female), median age 66 years, who were followed up for a median period of 19.2 months, received treatment for 49 vertebral metastases. A grade 3 acute mucosal adverse event occurred in 1 patient during the treatment and in 2 more at 1 month. No late neurologic adverse events were reported at 1 year. The mean pain scores diminished significantly at 1 month (1.35; P=.0125) and 3 months (0.77; P<.0001) compared with pain scores at study entry (2.49). Vertebral collapse in the irradiated zone occurred in 1 (2%) treated vertebra. Control of local disease was achieved in 94% of irradiated patients (3 local recurrences). Conclusion: The combination of zoledronate and HSRT in the treatment of vertebral metastasis is well tolerated and seems to reduce the rate of vertebral collapse, effectively relieve pain, and achieve good local tumor control with no late neurologic adverse effects.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Deeply conserved synteny resolves early events in vertebrate evolution

Although it is widely believed that early vertebrate evolution was shaped by ancient whole-genome duplications, the number, timing and mechanism of these events remain elusive. Here, we infer the history of vertebrates through genomic comparisons with a new chromosome-scale sequence of the invertebrate chordate amphioxus. We show how the karyotypes of amphioxus and diverse vertebrates are derived from 17 ancestral chordate linkage groups (and 19 ancestral bilaterian groups) by fusion, rearrangement and duplication. We resolve two distinct ancient duplications based on patterns of chromosomal conserved synteny. All extant vertebrates share the first duplication, which occurred in the mid/late Cambrian by autotetraploidization (that is, direct genome doubling). In contrast, the second duplication is found only in jawed vertebrates and occurred in the mid–late Ordovician by allotetraploidization (that is, genome duplication following interspecific hybridization) from two now-extinct progenitors. This complex genomic history parallels the diversification of vertebrate lineages in the fossil record.

59 BASIC BIOLOGICAL SCIENCES↗

Spatial complexity of carcass location influences vertebrate scavenger efficiency and species composition

Scavenging plays an important role in shaping communities through inter- and intra-specific interactions. Although vertebrate scavenger efficiency and species composition is likely influenced by the spatial complexity of environments, heterogeneity in carrion distribution has largely been disregarded in scavenging studies. We tested this hypothesis by experimentally placing juvenile bird carcasses on the ground and in nests in trees to simulate scenarios of nestling bird carrion availability. We used cameras to record scavengers removing carcasses and elapsed time to removal. Carrion placed on the ground was scavenged by a greater diversity of vertebrates and at > 2 times the rate of arboreal carcasses, suggesting arboreal carrion may represent an important resource to invertebrate scavengers, particularly in landscapes with efficient vertebrate scavenging communities. Nonetheless, six vertebrate species scavenged arboreal carcasses. Rat snakes (Elaphe obsolete), which exclusively scavenged from trees, and turkey vultures (Cathartes aura) were the primary scavengers of arboreal carrion, suggesting such resources are potentially an important pathway of nutrient acquisition for some volant and scansorial vertebrates. Our results highlight the intricacy of carrion-derived food web linkages, and how consideration of spatial complexity in carcass distribution (i.e., arboreal) may reveal important pathways of nutrient acquisition by invertebrate and vertebrate scavenging guilds.

59 BASIC BIOLOGICAL SCIENCES↗

Tissue-specific geometry and chemistry of modern and fossilized melanosomes reveal internal anatomy of extinct vertebrates

Recent discoveries of nonintegumentary melanosomes in extant and fossil amphibians offer potential insights into the physiological functions of melanin not directly related to color production, but the phylogenetic distribution and evolutionary history of these internal melanosomes has not been characterized systematically. Here, we present a holistic method to discriminate among melanized tissues by analyzing the anatomical distribution, morphology, and chemistry of melanosomes in various tissues in a phylogenetically broad sample of extant and fossil vertebrates. Our results show that internal melanosomes in all extant vertebrates analyzed have tissue-specific geometries and elemental signatures. Similar distinct populations of preserved melanosomes in phylogenetically diverse vertebrate fossils often map onto specific anatomical features. This approach also reveals the presence of various melanosome-rich internal tissues in fossils, providing a mechanism for the interpretation of the internal anatomy of ancient vertebrates. Collectively, these data indicate that vertebrate melanins share fundamental physiological roles in homeostasis via the scavenging and sequestering of metals and suggest that intimate links between melanin and metal metabolism in vertebrates have deep evolutionary origins.

59 BASIC BIOLOGICAL SCIENCES↗

Kummel Disease Treatment by Unipedicular Vertebral Augmentation Using Curved Injection Cannula

Purpose: This study was designed to evaluate the efficacy of the blunt-tipped curved injection needle (BCN) AVAflex (Care Fusion) for vertebral augmentation in cases of Kummel's disease. Methods: We performed 25 vertebral augmentation procedures on 25 consecutive patients (11 men/14 women; mean age, 67 years) with Kummel's disease using the blunt-tipped curved injection needle with PMMA cement. We performed all 25 procedures by unipedicular left approach with patients in prone position under local anesthesia and mild sedation. In all cases, an intravertebral cleft was evident on preprocedural imaging. We evaluated pain intensities by Visual Analogic Scale (VAS) before and at first day, 6 months, and 1 year after procedure. Results: In all cases the curved injection cannula permitted the filling of the clefts and surrounding cancellous bone without any complication. A significant reduction of kyphotic deformities of the treated vertebral bodies was evident. A significance decrease in VAS values at 1 year also was evident (mean decrease 7.2). At plain dynamic postprocedural X-rays checks, there was no sign of pathologic intravertebral motion as evidence of optimal stabilization. Conclusions: BCN AVAflex is a safe and effective device for targeted vertebral augmentation in cases of Kummel's disease. Its distinctive characteristic is the curved injection cannula, which enables targeting the cement injection to areas far off the trajectory of the straight access cannula, thus providing excellent cement spread throughout the entire volume of vertebral body.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Vertebral Augmentation with Nitinol Endoprosthesis: Clinical Experience in 40 Patients with 1-Year Follow-up

Purpose: This study was designed to assess the clinical outcomes of patients treated by vertebral augmentation with nitinol endoprosthesis (VNE) to treat painful vertebral compression fractures. Methods: Forty patients with one or more painful osteoporotic VCF, confirmed by MRI and accompanied by back-pain unresponsive to a minimum 2 months of conservative medical treatment, underwent VNE at 42 levels. Preoperative and postoperative pain measured with Visual Analog Scale (VAS), disability measured by Oswestry Disability Index (ODI), and vertebral height restoration (measured with 2-dimensional reconstruction CT) were compared at last follow-up (average follow-up 15 months). Cement extravasation, subsequent fractures, and implant migration were recorded. Results: Long-term follow-up was obtained in 38 of 40 patients. Both VAS and ODI significantly improved from a median of 8.0 (range 5–10) and 66 % (range 44–88 %) to 0.5 (range 0–8) and 6 % (range 6–66 %), respectively, at 1 year (p < 0.0001). Vertebral height measurements comparing time points increased in a statistically significant manner (ANOVA, p < 0.001). Overall cement extravasation rate was 9.5 %. Discal and venous leakage rates were 7.1 and 0 % respectively. No symptomatic extravasations occurred. Five of 38 (13.1 %) patients experienced new spontaneous, osteoporotic fractures. No device change or migration was observed. Conclusions: VNE is a safe and effective procedure that is able to provide long-lasting pain relief and durable vertebral height gain with a low rate of new fractures and cement leakages.

62 RADIOLOGY AND NUCLEAR MEDICINE↗