Pub Date : 2020-01-01DOI: 10.37421/2165-7939.2020.9.455
M. Singrakhia, I. Sha
Acute onset of neuropathic pain after lumbosacral fusion spine surgery can be due to multiple causes including a laterally directed bicortical S1 pedicle screw. We here are reporting a case where a laterally directed S1 pedicle screw irritating the L5 nerve root and producing a postoperative acute onset radicular pain on an unaffected side. After the failure of 1-month conservative treatment, the patient was operated and s1 screw was revised. While placing bicortical sacral screw, surgeons should stick to safe window described on cadaveric studies and MRI is a non-invasive and reliable method to identify and nerve root irritation by bicortical sacral screws.
{"title":"New-Onset Radiculopathy on Unaffected Side Post Spine Surgery-S1 Screw Irritating L5 Nerve Root: A Case Report","authors":"M. Singrakhia, I. Sha","doi":"10.37421/2165-7939.2020.9.455","DOIUrl":"https://doi.org/10.37421/2165-7939.2020.9.455","url":null,"abstract":"Acute onset of neuropathic pain after lumbosacral fusion spine surgery can be due to multiple causes including a laterally directed bicortical S1 pedicle screw. We here are reporting a case where a laterally directed S1 pedicle screw irritating the L5 nerve root and producing a postoperative acute onset radicular pain on an unaffected side. After the failure of 1-month conservative treatment, the patient was operated and s1 screw was revised. While placing bicortical sacral screw, surgeons should stick to safe window described on cadaveric studies and MRI is a non-invasive and reliable method to identify and nerve root irritation by bicortical sacral screws.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"9 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70050377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It the medical condition related to a person’s spine curve which is having sideways curve, usually S or C shaped over three dimensions. In some cases the degree of curve is stable and in others it increases over time. Cause of the most cases is not clear but believes that different factors involved like genetic and environmental factors. There are different types and causes of scoliosis, such as idiopathic, degenerative, congenital, neuromuscular, thoracogenic and syndromic. Idiopathic meaning itself says there is no specific cause but it is the most common form among 80 percent of the scoliosis cases, degenerative case is also fairly common like it affects around 39 percent of the population, rare forms includes congenital scoliosis which affects one in ten thousand newborns. Infantile idiopathic scoliosis will be diagnosed in children of ages 0-3, juvenile idiopathic scoliosis will be diagnosed in children of age 4-10, adolescent idiopathic scoliosis is diagnosed in young people ages 11-18, girls are experienced this much more frequently than boys at ratio of 10:1. Adult idiopathic or degenerative scoliosis is diagnosed in people older than 18. Degenerative scoliosis results from asymmetrical disc degeneration over time this type of scoliosis tends to affect the lumbar spine region, people with this problem will experience difficulty in standing upright and pain in the back.
{"title":"An Editorial Note on Scoliosis","authors":"K. Mano","doi":"10.37421/JSP.2020.9.457","DOIUrl":"https://doi.org/10.37421/JSP.2020.9.457","url":null,"abstract":"It the medical condition related to a person’s spine curve which is having sideways curve, usually S or C shaped over three dimensions. In some cases the degree of curve is stable and in others it increases over time. Cause of the most cases is not clear but believes that different factors involved like genetic and environmental factors. There are different types and causes of scoliosis, such as idiopathic, degenerative, congenital, neuromuscular, thoracogenic and syndromic. Idiopathic meaning itself says there is no specific cause but it is the most common form among 80 percent of the scoliosis cases, degenerative case is also fairly common like it affects around 39 percent of the population, rare forms includes congenital scoliosis which affects one in ten thousand newborns. Infantile idiopathic scoliosis will be diagnosed in children of ages 0-3, juvenile idiopathic scoliosis will be diagnosed in children of age 4-10, adolescent idiopathic scoliosis is diagnosed in young people ages 11-18, girls are experienced this much more frequently than boys at ratio of 10:1. Adult idiopathic or degenerative scoliosis is diagnosed in people older than 18. Degenerative scoliosis results from asymmetrical disc degeneration over time this type of scoliosis tends to affect the lumbar spine region, people with this problem will experience difficulty in standing upright and pain in the back.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"9 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70062025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.37421/2165-7939.2020.9.448
E. Ruggiero, S. Costanzo, A. Castelnuovo, M. Persichillo, S. Esposito, S. Magnacca, Ettore Carpineta, C. Cerletti, M. Bonaccio, M. Donati, S. Paolini, V. Esposito, G. Gaetano, G. Innocenzi, L. Lacoviello
Background and aim: Atherothrombotic disease of feeding arteries of lumbar spine could be an underlying mechanism for Lumbar Spinal Stenosis (LSS). We aimed at evaluating the association of a large panel of risk factors for atherothrombotic disease, alone or in combination, with LSS in multivariable models. Methods: Case-control study: 213 consecutive patients with LSS, eligible for surgery at the Neurosurgery Department of IRCCS Neuromed, were enrolled in the PREFACE study; 426 controls, matched 1: 2 for sex, age (± 6 months) and physical activity, without a history or clinical evidence of LSS were selected from the general population. Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were calculated using conditional-tomatch (for age and sex) logistic regression. Results: Manual occupation, current smoking, high waist-to-hip ratio, history of hypertension, diabetes and dyslipidemia were independently associated with higher odds of developing LSS in multivariable analysis (p<0.001). Only 1.5% of patients with LSS showed absence of risk factors, in comparison with 6.7% in controls (p<0.001). The risk of LSS linearly increased with the increased presence of risk factors. The presence of 3 or more risk factors compared with none was associated with 13 times higher risk of LSS (OR: 13.04; 95% CI: 2.87-59.27) Conclusion: Risk factors for cardiovascular disease and in particular metabolic risk factors are associated with increased risk of LSS. Management of LSS should take into consideration the control of modifiable atherothrombotic risk factors.
{"title":"Risk Factors for Atherothrombotic Disease and Lumbar Spinal Stenosis: Results from the PREFACE Study","authors":"E. Ruggiero, S. Costanzo, A. Castelnuovo, M. Persichillo, S. Esposito, S. Magnacca, Ettore Carpineta, C. Cerletti, M. Bonaccio, M. Donati, S. Paolini, V. Esposito, G. Gaetano, G. Innocenzi, L. Lacoviello","doi":"10.37421/2165-7939.2020.9.448","DOIUrl":"https://doi.org/10.37421/2165-7939.2020.9.448","url":null,"abstract":"Background and aim: Atherothrombotic disease of feeding arteries of lumbar spine could be an underlying mechanism for Lumbar Spinal Stenosis (LSS). We aimed at evaluating the association of a large panel of risk factors for atherothrombotic disease, alone or in combination, with LSS in multivariable models. Methods: Case-control study: 213 consecutive patients with LSS, eligible for surgery at the Neurosurgery Department of IRCCS Neuromed, were enrolled in the PREFACE study; 426 controls, matched 1: 2 for sex, age (± 6 months) and physical activity, without a history or clinical evidence of LSS were selected from the general population. Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were calculated using conditional-tomatch (for age and sex) logistic regression. Results: Manual occupation, current smoking, high waist-to-hip ratio, history of hypertension, diabetes and dyslipidemia were independently associated with higher odds of developing LSS in multivariable analysis (p<0.001). Only 1.5% of patients with LSS showed absence of risk factors, in comparison with 6.7% in controls (p<0.001). The risk of LSS linearly increased with the increased presence of risk factors. The presence of 3 or more risk factors compared with none was associated with 13 times higher risk of LSS (OR: 13.04; 95% CI: 2.87-59.27) Conclusion: Risk factors for cardiovascular disease and in particular metabolic risk factors are associated with increased risk of LSS. Management of LSS should take into consideration the control of modifiable atherothrombotic risk factors.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"9 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70049754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.37421/2165-7939.2020.9.456
Pang Hung Wu, H. Kim, D. Heo, Gamaliel Tan, Taesu Jang
Background: There is an increase in interest of endoscopic spine surgery as an option of minimally invasive spine surgery. Complications associated with learning curve are a big obstacle to starting a successful endoscopic career. A good endoscopic spine surgery fellowship can mitigate the risk of practice in early phase in endoscopic spine surgery. Methods: We conducted a systematic review in the PubMed database using the terms using three successive searches.10 articles met the criteria of learning curve in endoscopic surgeries evaluation of complications and operation timing. The most consistent parameters used in these studies to evaluate the learning curve were procedure time and complication rate as a function of chronologic case number, our analysis focused on these. The search strategy identified 10 original studies that included 618 endoscopic spine surgery procedures. Results: In the 10 studies, total number of complications was 45 cases (7.2%). 33 cases (5.3%) occurred in the early phase of learning curve. The most frequent reported complications were incomplete decompression (18 cases, 2.9%), incidental durotomies (13 cases; 2.1%), nerve root injuries (11 cases; 1.77%), discitis (2 cases; 0.32% of complications) and hematoma (1 case; 0.16%). The operative time was observed to decrease throughout these case series with no general consensus of number of cases required to reach asymptote. Conclusion: There is steep learning curve with high complications in the initial learning phase of endoscopic spine surgery. It is recommended to have an effective training or fellowship programme to train competent endoscopic spine surgeons.
{"title":"A Systematic Review of Complications Associated with Initial Learning Curve of Endoscopic Spine Surgery Highlighting the Necessity of Introducing an Effective Fellowship to Train Competent Endoscopic Spine Surgeons","authors":"Pang Hung Wu, H. Kim, D. Heo, Gamaliel Tan, Taesu Jang","doi":"10.37421/2165-7939.2020.9.456","DOIUrl":"https://doi.org/10.37421/2165-7939.2020.9.456","url":null,"abstract":"Background: There is an increase in interest of endoscopic spine surgery as an option of minimally invasive spine surgery. Complications associated with learning curve are a big obstacle to starting a successful endoscopic career. A good endoscopic spine surgery fellowship can mitigate the risk of practice in early phase in endoscopic spine surgery. Methods: We conducted a systematic review in the PubMed database using the terms using three successive searches.10 articles met the criteria of learning curve in endoscopic surgeries evaluation of complications and operation timing. The most consistent parameters used in these studies to evaluate the learning curve were procedure time and complication rate as a function of chronologic case number, our analysis focused on these. The search strategy identified 10 original studies that included 618 endoscopic spine surgery procedures. Results: In the 10 studies, total number of complications was 45 cases (7.2%). 33 cases (5.3%) occurred in the early phase of learning curve. The most frequent reported complications were incomplete decompression (18 cases, 2.9%), incidental durotomies (13 cases; 2.1%), nerve root injuries (11 cases; 1.77%), discitis (2 cases; 0.32% of complications) and hematoma (1 case; 0.16%). The operative time was observed to decrease throughout these case series with no general consensus of number of cases required to reach asymptote. Conclusion: There is steep learning curve with high complications in the initial learning phase of endoscopic spine surgery. It is recommended to have an effective training or fellowship programme to train competent endoscopic spine surgeons.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"9 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70050391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harsh Kumar Kanhaiya, Hasan Md. Arif Raihan, P. Lenka, A. Biswas
Study design: Prospective pre-post quasi experimental study design (Level of Evidence-IV). Objectives: Objective was to find the effectiveness of Molded LSO on postural sway and Pain in subject with NSCLBP. Background of the data: In orthotic treatment molded Lumbosecral orthosis (LSO) application is still controversial topic in Non-specific Chronic Low Back Pain (NSCLBP). Many studies are concentrated upon postural balance and pain with Spinal orthosis in NSCLBP have significant interrelationship but spinal orthosis with postural balance improvement have no strong evidence but this is an attempt to check the effect on COP and Pain using orthosis. This study will stabilized a clinical report on NSCLBP in terms with COP-sway and Pain in Indian scenario. Materials and methods: 30 subjects with NSCLBP were included in this study by convenient sampling method. The Postural sway parameters (COP, RMS & Range) in mediolateral (Ax) and anterio-posterior (Ay) direction measured using Kistler force plate in Eye open (EO) and Eye Close (EC) condition and pain using VAS. All the measurements was acquired as baseline (pre) with and without molded LSO, and after (Post) 4 weeks following onset of Molded LSO use. Results: There was significant difference between pre and post with & without Molded LSO postural sway in mediolateral (Ax) and anterio-posterior (Ay) of COP in both EO and EC condition, (p≤0.05). RMS was in without brace EC and EO and with brace EO in Ay and was in Ax, EO without brace and EC and EO with brace (p ≤ 0.05). Range in Ay EO without brace, and in with brace EO were Ax in EO with brace (p ≤ 0.05). VAS score mean differences were decreased in without and with braces but statistically not significant within groups. Conclusion: As per present perspective clinical evident report it going to conclude that molded Lumbosacral Orthosis have a significance impact on positive influences for reducing postural sway and pain in short term orthotic treatment protocol. It have positive impact on static postural balance and pain with saliently maintaining the lower COG alignment and unloading lumbar spine by using molded Lumbosacral Orthosis in subjects. One center prospective short term clinical report cannot indiscriminate the positive impact of molded Lumbosacral Orthosis in NSCLBP. So the molded Lumbosacral Orthosis can be recommended as a RCT study on this prospect for short term use orthotic plan in NSCLBP.
{"title":"Effect of Molded Lumbosacral Orthosis on Postural Sway and Pain in Subjects with Chronic Non-Specific Low Back Pain: A Prospective Study","authors":"Harsh Kumar Kanhaiya, Hasan Md. Arif Raihan, P. Lenka, A. Biswas","doi":"10.37421/JSP.2020.9.445","DOIUrl":"https://doi.org/10.37421/JSP.2020.9.445","url":null,"abstract":"Study design: Prospective pre-post quasi experimental study design (Level of Evidence-IV). Objectives: Objective was to find the effectiveness of Molded LSO on postural sway and Pain in subject with NSCLBP. Background of the data: In orthotic treatment molded Lumbosecral orthosis (LSO) application is still controversial topic in Non-specific Chronic Low Back Pain (NSCLBP). Many studies are concentrated upon postural balance and pain with Spinal orthosis in NSCLBP have significant interrelationship but spinal orthosis with postural balance improvement have no strong evidence but this is an attempt to check the effect on COP and Pain using orthosis. This study will stabilized a clinical report on NSCLBP in terms with COP-sway and Pain in Indian scenario. Materials and methods: 30 subjects with NSCLBP were included in this study by convenient sampling method. The Postural sway parameters (COP, RMS & Range) in mediolateral (Ax) and anterio-posterior (Ay) direction measured using Kistler force plate in Eye open (EO) and Eye Close (EC) condition and pain using VAS. All the measurements was acquired as baseline (pre) with and without molded LSO, and after (Post) 4 weeks following onset of Molded LSO use. Results: There was significant difference between pre and post with & without Molded LSO postural sway in mediolateral (Ax) and anterio-posterior (Ay) of COP in both EO and EC condition, (p≤0.05). RMS was in without brace EC and EO and with brace EO in Ay and was in Ax, EO without brace and EC and EO with brace (p ≤ 0.05). Range in Ay EO without brace, and in with brace EO were Ax in EO with brace (p ≤ 0.05). VAS score mean differences were decreased in without and with braces but statistically not significant within groups. Conclusion: As per present perspective clinical evident report it going to conclude that molded Lumbosacral Orthosis have a significance impact on positive influences for reducing postural sway and pain in short term orthotic treatment protocol. It have positive impact on static postural balance and pain with saliently maintaining the lower COG alignment and unloading lumbar spine by using molded Lumbosacral Orthosis in subjects. One center prospective short term clinical report cannot indiscriminate the positive impact of molded Lumbosacral Orthosis in NSCLBP. So the molded Lumbosacral Orthosis can be recommended as a RCT study on this prospect for short term use orthotic plan in NSCLBP.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"9 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70062425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2165-7939.1000434
Kirzner N, Gallagher C, K. L, F. D, M. W, L. S, Humadi A
{"title":"A Comparative Study between Opportunistic Lumbar Spine CT Scan and DEXA Scan in the Assessment of Osteoporosis","authors":"Kirzner N, Gallagher C, K. L, F. D, M. W, L. S, Humadi A","doi":"10.4172/2165-7939.1000434","DOIUrl":"https://doi.org/10.4172/2165-7939.1000434","url":null,"abstract":"","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2165-7939.1000432
E. Ekediegwu, Chike Chuka, I. Nwosu, C. Uchenwoke, N. Ekechukwu, A. Odole
{"title":"A Case Series of Non-Surgical Spinal Decompression as an Adjunct to Routine Physiotherapy Management of Patients with Chronic Mechanical Low Back Pain","authors":"E. Ekediegwu, Chike Chuka, I. Nwosu, C. Uchenwoke, N. Ekechukwu, A. Odole","doi":"10.4172/2165-7939.1000432","DOIUrl":"https://doi.org/10.4172/2165-7939.1000432","url":null,"abstract":"","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2165-7939.1000438
A. Humadi, N. Kirzner, Sulaf Darwood, G. Quan
Metastatic spine disease is increasing in incidence and is a major cause for patient morbidity and mortality. The clinical presentation is often characterised by pain and spinal deformity and often progresses to neurological deficits without treatment. The cornerstones of treatment have been chemotherapy, radiation therapy and surgery to debulk and stabilize the spine. However, these are considered palliative procedures being limited by damage to normal healthy tissues. Recent studies have focused on the key pathways that mediate tumour progression and spread to bone and more targeted therapies that may reduce the injury to normal cells. This article reviews the key features, clinical presentation, workup and treatment options of spinal metastases.
{"title":"A Review of the Literature on Metastatic Spine Disease","authors":"A. Humadi, N. Kirzner, Sulaf Darwood, G. Quan","doi":"10.4172/2165-7939.1000438","DOIUrl":"https://doi.org/10.4172/2165-7939.1000438","url":null,"abstract":"Metastatic spine disease is increasing in incidence and is a major cause for patient morbidity and mortality. The clinical presentation is often characterised by pain and spinal deformity and often progresses to neurological deficits without treatment. The cornerstones of treatment have been chemotherapy, radiation therapy and surgery to debulk and stabilize the spine. However, these are considered palliative procedures being limited by damage to normal healthy tissues. Recent studies have focused on the key pathways that mediate tumour progression and spread to bone and more targeted therapies that may reduce the injury to normal cells. This article reviews the key features, clinical presentation, workup and treatment options of spinal metastases.","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"8 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2165-7939.1000431
Y. Gu, L. Zhang, Wang Yc, J. Dong
{"title":"Minimally Invasive Posterior Decompression and Percutaneous Pedicle Screws Fixation for Thoracic Metastatic Tumor","authors":"Y. Gu, L. Zhang, Wang Yc, J. Dong","doi":"10.4172/2165-7939.1000431","DOIUrl":"https://doi.org/10.4172/2165-7939.1000431","url":null,"abstract":"","PeriodicalId":89593,"journal":{"name":"Journal of spine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7939.1000431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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