ABSTRACT
PURPOSE: To analyze the effect of adjacent vertebral body on local sagittal segment in performing vertebroplasty for thoracolumabr vertebral compression fracture on the terms of radiological results. MATERIALS AND METHODS: We experienced 61 cases of T12 and L1 Compression fracture between June 2003 and November 2005. We classified with 3 groups; no collapse of adjacent body, collapse of adjacent upper body, and collapse of adjacent lower body. The measuring factors were anterior, middle, posterior vertebral height, wedge angle and local kyphotic angle. RESULTS: In group I, Increase rate of anterior, middle, posterior vertebral height and restoration rate of wedge angle, and local kyphotic angle were average of 0.41%, 0.31%, 0.16%, 1.47%, ?3.48% respectively. Group II was -3.19%, 0.11%, -3.02%, -1.23%, -4.63%. Group III was -2.28%, 4.72%, -1.01%, -2.41%, -13.12%. There are no significant differences among the groups except local kyphotic angle in Group III statistically. CONCLUSION: The previous wedged collapse of adjacent vertebral body do not affect local sagittal segment performed vertebroplasty in the thoracolumbar compression fracture. However the previous wedged collapse of adjacent lower body affect significantly local kyphotic angle.
Subject(s)
Fractures, Compression , VertebroplastyABSTRACT
STUDY DESIGN: A prospective radiologic assessment. OBJECTIVES: To compare the changes of dimensions of the intervertebral disc and neural foramen between the anterior lumbar interbody fusion and the posterolateral fusion in the lumbar spine. SUMMARY OF LITERATURE REVIEW: There are few reports comparing an anterior lumbar interbody fusion with pedicle screw fixation and a posterolateral fusion with pedicle screw fixation. MATERIALS AND METHODS: We studied 62 patients with degenerative lumbar diseases who underwent minimal anterior lumbar interbody fusion with pedicle screw fixation (group I, 40 patients) or who underwent posterolateral fusion with pedicle screw fixation (group II, 22 patients). We measured the height of disc and the height, width, and area of the neural foramen measured in 1-mm reconstructive sagittal images of computed tomography before and 6 months after the operation. The factors were independently measured by three different observers. RESULTS: Disc height was increased by a mean of 39.1+/-3.28% in group I and 3.1+/-2.99% in group II. The height of the neural foramen was increased by a mean of 18.7+/-4.21% in I and 1.0+/-2.34% in II. The area of neural foramen was increased by a mean of 21.5+/-3.50% in I and -2.1+/-4.39% in II, with significant differences between groups in all parameters. CONCLUSION: The minimal anterior lumbar interbody fusion with pedicle screw fixation was superior to posterolateral fusion with pedicle screw fixation for increasing disc height and the height and area of neural foramen.
Subject(s)
Humans , Intervertebral Disc , Prospective Studies , SpineABSTRACT
PURPOSE: To compare the outcome of vertebroplasty with kyphoplasty in the treatment of painful osteoporotic vertebral compression fractures. MATERIALS AND METHODS: From May 2002 through April 2004, 55 patients were analyzed. Vertebroplasties were performed on 29 patients under local anesthesia. The patients were divided into two groups: group I consisted of 15 patients who underwent vertebroplasties within two weeks from the onset of the fractures; group II consisted of 14 patients who underwent kyphoplasties after two weeks from the onset of the fractures. Kyphoplasties were performed on 26 patients under general anesthesia. These patients were also divided into two groups, based on the same criteria as those patients who underwent vertebroplasties. For the radiological assessment, we measured the kyphotic angle with Cobb's method and the reduction rate in the anterior, middle, and posterior portions of the vertebral bodies. The clinical results were assessed with the Oswestry Disability Index and Visual Analogue Scale. RESULTS: The reduction rates of the anterior and middle portions of the vertebral bodies were greater than 50 % in patients who underwent vertebroplasties within two weeks from the onset of the fractures and the patients who received kyphoplasty. The reduction rates of the anterior and middle parts of the vertebral bodies in patients who underwent vertebroplasties after two weeks from the onset of the fractures, was much less than in other three groups. There were no significant differences in clinical comparison among the 4 groups: i.e., all the patient had satisfactory results in terms of pain relief and pre-fracture activity levels. CONCLUSION: We obtained better results from kyphoplasties when we compared vertebroplasties with kyphoplasties, regardless of the operation dates. However, when we performed vertebroplasties within two weeks from the onset of the fractures, we obtained radiological results that were similar to those with kyphoplasties. In clinical comparison, there were no statistically significant differences among the 4 groups. The pain scores improved dramatically after the operations and pre-fracture activity levels resumed.
Subject(s)
Humans , Anesthesia, General , Anesthesia, Local , Fractures, Compression , Kyphoplasty , Spine , VertebroplastyABSTRACT
We report one case of bilateral naviculo-medial cuneiform coalition in ten year old girl. She complained of pain in the medial aspect of the mid-foot related to long periods of standing and activity. Routine roentgenographs, specifically lateral views showed a bony bridge between the navicular bone and medial cuneiform. A biopsy revealed as fibrocartilaginous tissue. The bony bridge consists about one third in lateral view and 30 degree cephalad tilting in the antero-posterior view. Bilateral resection arthroplasty, with interposing flesh muscle fibers of the abductor hallucis, was performed for restoration of motion in the naviculo-medial cuneiform joint and relief of localized pain. Four months after surgery, pain around the mid-foot had almost complete subsided. One year postoperative, neither recurrence nor disability was observed. We will discuss the diagnosis and treatment of this rare case of bilateral naviculo-medial cuneiform coalition.
Subject(s)
Female , Humans , Arthroplasty , Biopsy , Diagnosis , Joints , RecurrenceABSTRACT
No abstract available.