The effect of pulsed jet lavage in vertebroplasty on injection forces of PMMA bone cement: an animal study

Percutaneous vertebroplasty, comprising of the injection of polymethylmethacrylate (PMMA) into vertebral bodies, is an efficient procedure to stabilize osteoporotic compression fractures as well as other weakening lesions. Besides fat embolism, cement leakage is considered to be one of the major and most severe complications during percutaneous vertebroplasty. The viscosity of the PMMA during injection plays a key role in this context. It was shown in vitro that the best way to lower the risk of cement leakage is to inject the cement at higher viscosity, which is requires high injection forces. Injection forces can be reduced by applying a newly developed lavage technique as it was shown in vitro using human cadaver vertebrae. The purpose of this study was to prove the in vitro results in an in vivo model. The investigation was incorporated in an animal study that was performed to evaluate the cardiovascular reaction on cement augmentation using the lavage technique. Injection forces were measured with instrumentation for 1 cc syringes, additionally acquiring plunger displacement. Averaged injection forces measured, ranged from 12 to 130 N and from 28 to 140 N for the lavage group and the control group, respectively. Normalized injection forces (by viscosity and injection speed) showed a trend to be lower for the lavage group in comparison to the control group (P = 0.073). In conclusion, the clinical relevance on the investigated lavage technique concerning lowering injection forces was only shown by trend in the performed animal study. However, it might well be that the effect is more pronounced for osteoporotic vertebral bodies.

Factorization and N3LLp+NNLO predictions for the Higgs cross section with a jet veto

We have recently derived a factorization formula for the Higgs-boson production cross section in the presence of a jet veto, which allows for a systematic resummation of large Sudakov logarithms of the form αn s lnm(pveto T /mH), along with the large virtual corrections known to affect also the total cross section. Here we determine the ingredients entering this formula at two-loop accuracy. Specifically, we compute the dependence on the jet-radius parameter R, which is encoded in the two-loop coefficient of the collinear anomaly, by means of a direct, fully analytic calculation in the framework of soft-collinear effective theory. We confirm the result obtained by Banfi et al. from a related calculation in QCD, and demonstrate that factorization-breaking, soft-collinear mixing effects do not arise at leading power in pveto T /mH, even for R = O(1). In addition, we extract the two-loop collinear beam functions numerically. We present detailed numerical predictions for the jet-veto cross section with partial next-to-next-to-next-to-leading logarithmic accuracy, matched to the next-to-next-to-leading order cross section in fixed-order perturbation theory. The only missing ingredients at this level of accuracy are the three-loop anomaly coefficient and the four-loop cusp anomalous dimension, whose numerical effects we estimate to be small.