ABSTRACT
Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in surgical treatment of osteoporotic thoracolumbar vertebral compression fracture in the elderly.Methods From March 2007 to February 2013,210 cases (100 males and 110 females;55-91 years of age,mean 72.5 years) of osteoporotic vertebral compression fracture were treated with PKP.Single-segment fracture was observed in 180 cases,two-segment fracture in 20 cases and three-segment fracture in 10 cases.Lesion involved in 250 vertebrae located in the T6-L5 segment.Bone cement injected into each vertebra was 3-5 ml (mean,4 ml).Treatment effects were assessed with vertebral height,Cobb angle and visual analogue score (VAS).Results At the follow-up of 6-15 months (mean 11 months),thoracic back pain significantly alleviated or disappeared.After operation,improvements were observed in VAS [(8.7 ± 1.2) points vs (2.6 ±0.7) points],anterior vertebral height loss [(11.0 ±3.2) mm vs(5.5 ± 0.8) mm],central vertebral height loss [(8.6 ± 1.1)mm vs (3.3 ± 1.0) mm],and Cobb angle [(29.8 ± 4.5) ° vs (16.7 ± 3.4) °] (P ＜ 0.01).Four patients appeared no pain or numbness in lower limbs although cement leak into disc.Whereas two patients had lower extremity nerve irritation because of cement leak into the spinal canal and recovered after symptomatic treatment.Conclusion PKP is an effective method for treatment of osteoporotic vertebral compression fracture in the elderly,for it can rebuild vertebral height,increase vertebral rigidity as well as stability and relieve thoracic back pain.
ABSTRACT
Background and purpose:Glutamine is the major fuel for the enterocyte and major energy origin of intestinal mucosal cell which prevent gastrointestinal mucosal cell from atrophying.Although there were a lot of studies of how to protect the gastrointestinal mucosal in various stress,such as trauma,burn and complex operation,but the impact of how the glutamine affected the gastrointestinal mucosa in the period of chemotheraphy was rarely reported.Our aim was to investigate the protective effects of glutamine for the morphological and functional damage of gastrointestinal mucosa induced by introperitoneally fluorouracil(5-FU) in rats in order to find the ways to prevent the intestinal mucosa from damage in the period of chemotherapy.Methods:Forty Wistar rats were randomly divided into four groups:A:Blank control group,B:5-FU group,C:5-FU + Glycin group,D:5-FU + Glutamine group.The rats in group C were given Glycin,group D glutamine(0.35 g/kg each).Group B,group C and group D received 5-FU(100 mg/kg) injection intraperitoneally on the fourth day respectively to make the model of gastrointestinal barrier injury.The content of endotoxin in peripheral blood was measured in all groups after the rats were killed on the seventh day.The mesenteric lymph nodes(MLN) and liver were harvested for comparison of bacterial translocation incidence among the four groups.Ileum tissue was taken for pathologic examination including comparison of mucosal thickness,villus height and width and morphology change of ileum of each group.Results:The test showed that the weight and the height,the width,the thickness of the villus intestinal mucosa of group D were more than those of groupB and group C.The content of endotoxin in peripheral blood and the positive cases of bacterial translocation in MLN and liver of group D were less than group B and group C.The weight and the height,the width and the thickness of the villus intestinal mucosa of group A were more than those of group B,group C,and group D.The content of endotoxin in peripheral blood and the positive cases of bacterial translocation of MLN and liver of group A were less than group B,group C and group D.Conclusion:There were damage to the rat's gastrointestinal mucosa during the giving of 5-FU intraperitoneally.Glutamine could protect rat's gastrointestinal mucosa from damage during the giving of 5-FU intraperitoneally.Glycin could not protect rat's gastrointestinal mucosa against from damage during the giving of 5-FU intraperitoneally.