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        Free Vascularized Fibular Strut Autografts to the Lumbar Spine in Complex Revision Surgery: A Report of Two Cases

        Bryan M. Saltzman,David M. Levy,Venus Vakhshori,Christopher J. DeWald 대한척추신경외과학회 2015 Neurospine Vol.12 No.3

        This case report presents two patients who underwent fibular strut grafting for complex revisions of previous lumbar spine arthrodeses. A case review of the Electronic Medical Record at the index institution was performed to evaluate the timeline of events of the two patients who underwent fibular strut grafting for complex revisions of previous lumbar spine arthrodesis, including imaging studies, progress notes, and laboratory results. One patient had developed chronic L3 vertebral body osteomyelitis from a prior fibular allograft and instrumentation placed for a traumatic burst fracture. The second patient had a severe scoliosis recalcitrant to prior arthrodeses in the context of Marfan syndrome and a persistent L4-5 pseudarthrosis. Both patients underwent free vascularized fibular autograft revision arthrodeses. At most recent long-term follow-up, both patients had improved clinically and neither had required further revision. The use of free vascularized fibular grafting is an excellent option for a variety of spinal indications, and these two reports indicate that the technology may have an indication for use after multiple failed surgeries for osteomyelitis or correction of a multi-level large spinal deformity secondary to Marfan syndrome.

      • Recovering stereo vision by squashing virtual bugs in a virtual reality environment

        Vedamurthy, Indu,Knill, David C.,Huang, Samuel J.,Yung, Amanda,Ding, Jian,Kwon, Oh-Sang,Bavelier, Daphne,Levi, Dennis M. Royal Society 2016 Philosophical transactions. Biological sciences Vol.371 No.1697

        <P>Stereopsis is the rich impression of three-dimensionality, based on binocular disparity-the differences between the two retinal images of the same world. However, a substantial proportion of the population is stereo-deficient, and reliesmostly onmonocular cues to judge the relative depth or distance of objects in the environment. Here we trained adults who were stereo blind or stereodeficient owing to strabismus and/or amblyopia in a natural visuomotor task-a 'bug squashing' game-in a virtual reality environment. The subjects' task was to squash a virtual dichoptic bug on a slanted surface, by hitting it with a physical cylinder they held in their hand. The perceived surface slant was determined by monocular texture and stereoscopic cues, with these cues being either consistent or in conflict, allowing us to track the relative weighting of monocular versus stereoscopic cues as training in the task progressed. Following training most participants showed greater reliance on stereoscopic cues, reduced suppression and improved stereoacuity. Importantly, the training-induced changes in relative stereo weights were significant predictors of the improvements in stereoacuity. We conclude that some adults deprived of normal binocular vision and insensitive to the disparity information can, with appropriate experience, recover access to more reliable stereoscopic information. This article is part of the themed issue 'Vision in our three-dimensional world'.</P>

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