Percutaneous vertebroplasty in iranian patients with osteoporotic vertebral fractures

Osteoporotic compression vertebral fractures are common clinical problems. In those with refractory fractures, percutaneous cement augmentation has been suggested. The aim of this study was to evaluate the functional outcome of percutaneous vertebroplasty in Iranian patients with refractory Osteoporotic fractures. We retrospectively studied 37 Osteoporotic fractures in 28 patients [6 men and 22 women], who had been treated with vertebroplasty from August 2009 to June 2012. The mean follow-up period was 12.1 +/- 3.6 [range: 6-42 months]. The patients' states were assessed by the visual analogue scale and short form-36 questionnaire. Student t test was used to analyze the pre- and postoperative data. The mean age of the patients was 71.6 +/- 6.1 [range: 50 to 91 years] and the most common fractured vertebrae were L1 and T12, There were five patients with two levels of vertebral fractures and two with three levels. Vertebroplasty could improve the scores for pain and quality of life from preoperative 7.6 +/- 1.4 and 44.8 +/- 7.6 to 1.8 +/- 0.4 and 74.1 +/- 5.3 at four weeks after surgery. At the last follow-up visit, this improvement continued with no significant decline. The most common complication was cement leakage [32.4% per vertebra], wherein all of of the patients were clinically asymptomatic. Adjacent vertebral fracture occurred in six cases. By understanding the risks, we propose vertebroplasty in Iranian patients with refractory Osteoporotic vertebral fracture. If correctly performed, this procedure can significantly improve the pain and quality of life in these elderly Osteoporotic patients

[Study the results of less invasive decompressive surgery in lumbar spinal stenosis]

Spinal stenosis of the lumbar area is the most common problem of this area in older patients and surgery is needed in refractory cases. The purpose of this study was to assess the surgical outcome of the less invasive decompressive surgery in the patients with lumbar spinal stenosis. In a retrospective study, we reviewed 50 cases with lumbar spinal stenosis that carried out this type of surgery and followed regularly. For assessing the results, we used anatomical economical functional rating system of Prolo, visual analogue scale and White and Panjabi instability criteria. The patients were followed-up for a mean of 3.5 years [2 to 8] after surgery. Good or excellent results were obtained in 82% of the patients. A significant reduction of the low back pain intensity and disability was seen. Claudication and radicular pain was disappeared in 100% and 94% of them, respectively. Less invasive decompressive surgery by limited laminotomy, undercutting of the facet joints and not doing extensive laminectomy is a safe and reliable surgery for the treatment of the refractory patients with lumbar spinal stenosis

Unusual presentation of iliac bone hydatid cyst

A 21-year-old woman presented with a painless growing mass in her right flank since 5 months before. With the probable diagnosis of a cold abscess, the patient was operated, but the wound was not cured. The patient was re-examined and a biopsy from the lesion was taken which revealed hydatid cyst. After nearly complete excision of the infected area and adjuvant chemotherapy with albendazole for 6 weeks, no recurrence was seen until 14 months after the operation

[Distal soft tissue surgery and proximal open wedge metatarsal osteotomy in hallux valgus]

Introduction: In the moderate and severe cases of hallux valgus with metatarsus valgus, one of the most important parts of surgical technique is proximal metatarsal osteotomy

Objective: In this study, the results of a distal soft tissue procedure and a medial open wedge proximal metatarsal osteotomy were reviewed

Materials and Methods: In this study we operated 22 feet [16 patients] with moderate or severe hallux valgus. In all the patients distal soft tissue procedure were done then with the bunion part of the metatarsal head medial open wedge proximal metatarsal osteotomy were done and fixed. Average follow up period was 13 months

Results: 13 patients were female. At follow up 16 feet were free from pain at the first metatarsophalyngeal joint. In 6 feet the pain was improved but persisted. The mean hallux valgus and intermetatarsal angles were 38 and 18 before and 13 and 6 after surgery respectively. The postoperative hallux valgus and intermetatarsal angles in patients who had pain at the first metatarsophalyngeal joint after surgery were greater than those in patients without pain after surgery

Conclusion: This procedure corrects moderate and severe hallux valgus deformity and relieves the symptoms effectively, but careful attention should be paid to the surgical technique to obtain consistent and satisfactory results