ABSTRACT
Objective To compare the clinical outcomes of dilator-kyphoplasty (DKP) and balloonkyphoplasty (BKP) in treatment of osteoporotic vertebral compression fractures. Methods From May 2007 to March 2009, 23 cases with 26 vertebrae were treated with DKP, while 29 cases with 29 vertebrae were treated with BKP procedures. The operating time, bleeding volume and injecting volume of cement were recorded during operation. The distribution of cement, the restoration of vertebral height and Cobb angle were observed. The patients' visual analogue scales (VAS) score and Oswestry disability index (ODI) score were evaluated after operation. Results There were no differences in operative time, bleeding volume of every vertebrae and cement injected volume between these two groups (P＞0.05). The vertebral height, Cobb angle, VAS and ODI scores were significantly improved than those of pre-operation in these two groups (P＜0.05). The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups (P＜ 0.05). There were 1 case (1 vertebra, 3.8%) underwent cement leakage in DKP groups and 5 cases (5 vertebrae, 17.2%) in BKP groups. Conclusion DKP and BKP were effective in the treatment of osteoporotic vertebral compression fractures. The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups.
ABSTRACT
BACKGROUND: There are many treatment approaches of the cervical spinal cord injury but the results were all unpleased.OBJECTIVE: To discuss the effect of the operation and other colligate treatments on the functional recovery of the patients who suffered from the cervical central spinal cord injury.DESIGN: A preoperative and postoperative control study.SETTING: Orthopaedic department in an affiliated hospital of a university.PARTICIPANTS: Eleven male patients of the central spinal cord injury,whose ages ranged from 36 to 65, were chosen from the Orthopedic Department of People' s Hospital of Jiangsu Province from January 1999 to January 2003. Nine cases suffered from traffic accidents. One case suffered from falling injury. One case suffered from head smash injury. The courses of diseases were from 2 hours to 14 days. Nine cases were accompanied with the cervical intervertebral disc herniation. One case was accompanied with the cervical vertebral canal stenosis. One case was accompanied with the fracture of the C6 vertebral body. Nine cases showed single segment injury and 2 cases showed two segment injuries in the MRI plate.METHODS: The operation was done 4 to 20 days after the injury. Anterior cervical intervertebral disc removal, bone implantation and the internal fixation of the armor plate were done in 9 cases. Posterior route cervical vertebral depression, bone implantation and internal fixation of the lateral armor plate were done in 2 cases.tion.RESULTS: Before the operation 11 cases were classified according to the Frankel Grade: 3 cases of 0 grade, 3 cases of Ⅰ grade and 5 cases of Ⅱ grade. After the operation 1 case of 0 grade, 4 cases of Ⅲ grade, and 6 cases of Ⅳ grade. The mean muscular power recovered 2 to 5 grades. The re-examination of the internal fixation was firm and right-located. The implanted bone healed well.CONCLUSION: After the diagnosis of the cervical central spinal cord injury, the colligate treatment is suggested. The operation removes the pathogenic factors as soon as possible, and other assistant treatments promote the functional recovery of the spinal cord.