ABSTRACT
BACKGROUND: Stellate ganglion block has the ability to improve the imbalance of the autonomic nervous system in perimenopausal syndrome. Lumbosacral plexus is an automatic nervous block, and exerts similar effects with stellate ganglion block. OBJECTIVE: To investigate the effect of lumbosacral plexus block on the serum level of hormones and histology of the ovary in rabbits, thus providing a new treatment strategy for perimenopausal syndrome. METHODS: This was a randomized controlled animal experiment, which was finished at the Animal Center of Guiyang Medical Unversity, China. The healthy rabbits were randomly divided into experimental and control groups, and underwent lumbosacral plexus block by injecting 0.5 mg of vitamin B12, 100 mg of lidocaine and 10 mL of normal saline into the psoas compartment, and the same volume of normal saline, respectively. The effect of lumbosacral plexus block on the serum levels of hormones (estradiol, gonadotropin releasing hormone, follicle-stimulating hormone and luteinizing hormone) at rabbit proestrus, estrus and metaestrus were observed, respectively. The pathological changes of the ovary in a complete estrus cycle were observed. The relationship between the treatment time of lumbosacral plexus block and the levels of hormones was investigated after 1, 3 and 6 complete estrus cycles. The experimental followed the national guidelines for the Care and Use of Laboratory Animals, and Consensus author guidelines on animal ethics and welfare by the International Association for Veterinary Editors (IAVE), and prepared in accordance with the Animal Research: Reporting of In Vivo Experiments Guidelines (ARRIVE Guidelines). RESULTS AND CONCLUSION: Lumbosacral plexus block can increase the serum level of estrogen, reduce the serum levels of follicle-stimulating hormone and luteinizing hormone, and regulate the hypothalamic-pituitary-ovary axis function. Presumably, it may be used as a treatment method or adjuvant therapy of perimenopausal syndrome. Future experiments are needed to explore the effect of lumbosacral plexus block on the serum levels of hormones in a rabbit after oophorectomy to determine whether it exhibits the same effect on ovarian failure.
ABSTRACT
Objective To investigate the clinical outcomes of percutaneous kyphoplasty (PKP) for treatment of vertebral compression fractures in perimenpausal women.Methods A total of 53 perimenopausal patients (70 vertebrae) undergone PKP for vertebral compression fractures from January 2007 to May 2014 were analyzed retrospectively by case-control study.Thirty-six patients had single vertebral fractures and 17 two-level vertebral fractures.The fracture segments included 5 T11 vertebrae,14 T12 vertebrae,30 L1 vertebrae,12 L2 vertebrae and 9 L3 vertebrae.Ratio of vertebral compression was 10％-30％.According to treatment difference,the patients were divided into PKP group and non-operation group.In PKP group,there were 30 patients with age range of 44-54 years (mean,51.0 years),and the fracture segments included 13 T11 vertebrae,11 T12 vertebrae,17 L1 vertebrae,7 L2 vertebrae,3 L3 vertebrae.In non-operation group,there were 23 patients with age range of 44-54 years (mean,50.5 years),and the fracture segments included 2 T11 vertebrae,3 T12 vertebrae,13 L1 vertebrae,5 L2 vertebrae,6 L3 vertebrae.Visual analogue scale (VAS),Oswesty disability index (ODI),vertebral compression rate,Cobb angle and bone mineral density change were compared preoperatively,2 weeks,6 months and 3 years after operation.Results All patients were followed up for 6-36 months.VAS and ODI were improved compared with preoperative status in two groups at 2 weeks,6 months and 3 years (P ＜ 0.01).VAS and ODI in PKP group were significantly decreased at 2 weeks and 6 months compared with non-operation group (P ＜ 0.01).The Cobb angle and vertebral compression rate in non-operation group were improved at 6 months compared with those in preoperative status (P ＜ 0.05),and a consistent increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group were reduced at 6 months compared with preoperative status (P ＜ 0.05),and an increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group did not increase at 6 months and 3 years,but they had significant increase in non-operation group (P ＜ 0.05).The body mass index in non-operation group decreased at different degrees at 6 months and 3 years,compared with preoperative status (P ＜ 0.05),while the body mass index reduction in PKP group had no statistically significant difference (P ＞ 0.05).The body mass index reduction in PKP group was less than that in non-operation group at 3 years (P ＜0.01).The body mass index reduction in PKP group was slow and had no statistically significant difference compared with preoperative status (P ＞ 0.05).The body mass index reduction in non-operation group was fast and had significant decrease compared with preoperative status (P ＜ 0.05).Conclusion PKP can relieve pain for vertebral compression fractures in perimenopausal women in short term and long term,and PKP can also improve spinal kyphosis and prohibit the decline of bone mineral density.
ABSTRACT
Objective To discuss the short-term curative effect and the safety of percutaneous vertebroplasty using high viscosity bone cement for the treatment of severe osteoporotic vertebral body compression fractures. Methods The clinical data of 100 patients with severe osteoporotic vertebral body compression fractures (compression degree>70%), who received percutaneous vertebroplasty by using high viscosity bone cement during the period from December 2010 to May 2013, were retrospectively analyzed. All the patients were followed up for at least one month. Both preoperative and postoperative visual analogue scale (VAS) and quality of life (QOL) scores, as well as the incidence of bone cement leakage, were recorded and the results were used to evaluate the curative effect and the safety of percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Results One week after the treatment, significant pain relief was obtained in 92 patients (92%), VAS scores decreased from preoperative (7.0 ±1.2) to postoperative (2.0±1.5), and QOL scores increased from preoperative (30±5.0) to postoperative (80±18.0);the differences were statistically significant (P0.05). Leakage of bone cement was observed in 40 patients (40%), resulting no severe neurological symptoms; among the 40 patients, intervertebral disc leakage at above and below the vertebral body was detected in 28 patients (70%), vertebral anterior edge leakage was observed in 11 patients (27.5%) and vertebral posterior edge leakage was seen in one patient (2.5%). Conclusion For the treatment of severe osteoporotic vertebral body compression fractures, percutaneous vertebroplasty by using high viscosity bone cement is safe and effective.