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OBJECTIVE@#To investigate the clinical effect of modified suspension reduction method combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures.@*METHODS@#From February 2020 to October 2021, 92 patients with thoracolumbar osteoporotic compression fracture were treated by percutaneous vertebroplasty. According to different treatment methods, they were divided into the observation group and the control group. The observation group was treated with modified suspension reduction and then percutaneous vertebroplasty, while the control group was treated with percutaneous vertebroplasty alone. The observation group (47 cases), including 20 males and 27 females, the age ranged from 59 to 76 years old with an average of (69.74±4.50) years old, fractured vertebral bodies:T10(2 cases), T11(7 cases), T12(19 cases), L1(14 cases), L2(5 cases);the control group(45 cases), including 21 males and 24 females, the age ranged from 61 to 78 years old with an average of (71.02±3.58) years old, fractured vertebral bodies:T10(3 cases), T11(8 cases), T12(17 cases), L1(12 cases), L2(5 cases);The leakage of bone cement were observed, the visual analogue scale (VAS), Oswestry lumbar dysfunction index (ODI), anterior vertebrae height (AVH), Cobb angle of kyphosis and the amount of bone cement injected before and after operation were recorded and compared between the two groups.@*RESULTS@#All patients were followed up, ranged from 6 to10 with an average of (8.45±1.73) months. Two patients ocurred bone cement leakage in observation group and 3 patients in control group. AVH of observation group increased (P<0.05) and Cobb angle of injured vertebrae decreased (P<0.05). Cobb angle of injured vertebrae and AVH of the control group were not significantly changed (P>0.05). Cobb angle of injured vertebrae of the observation group was lower than that of control group (P<0.05) and AVH was higher than that of the control group (P<0.05). In the observation group, VAS before operation and 1 week, 3 and 6 months after operation respectively were(7.32±1.05) scores, (3.56±1.18) scores, (1.83±0.67) scores, (1.27±0.34) scores, and ODI were(40.12±14.69) scores, (23.76±10.19) scores, (20.15±6.39) scores, (13.45±3.46) scores. In the control group, VAS before operation and 1 week, 3 and 6 months after operation respectively were(7.11±5.26) scores, (3.82±0.68) scores, (1.94±0.88) scores, (1.36±0.52) scores, and ODI were(41.38±10.23) scores, (25.13±14.22) scores , (20.61±5.82) scores, (14.55±5.27) scores . The scores of VAS and ODI after operation were lower than those before operation (P<0.05), but there was no significant difference between the two groups (P<0.05).@*CONCLUSION@#Modified suspension reduction method combined with PVP surgery for osteoporotic thoracolumbar compression fractures has achieved good clinical results, which can effectively relieve lumbar back pain, restore vertebral height, correct kyphosis, improve lumbar function and patients' quality of life.
Subject(s)
Male , Female , Humans , Middle Aged , Aged , Bone Cements/therapeutic use , Vertebroplasty/methods , Fractures, Compression/surgery , Quality of Life , Treatment Outcome , Spinal Fractures/surgery , Lumbar Vertebrae/injuries , Osteoporotic Fractures/surgery , Kyphosis/surgery , Retrospective StudiesABSTRACT
Objective To evaluate the clinical effects of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) on lumbar spondylolisthesis and lumbar instability in Chinese patients.Methods Literatures about clinical effects of TLIF and PLIT on lumbar spondylolisthesis and lumbar instability were collected from Chinese academic literature database (CNKI),Chinese biomedical literature database (CMBdisc),Wanfang database and Chinese journals of orthopedics.Data from those literatures including operation time,bleeding volume,surgical complications,postoperative interspace height,visual analog scale (VAS) score,Oswestry Disability Index (ODI) and improvement rate of Japanese Orthopedic Association (JOA) score were analyzed by Stata SE 11.2 software.Results A total of 12 literatures met the inclusion criteria and 1041 cases were included (PLIF group,n=520; PLIF group,n=521).The operation time was longer in PLIF group than in TLIF group [standardized mean difference (SMD)=1.26,95％CI:0.58-1.94,P＜0.001].The bleeding volume was more in PLIF group than in TLIF group SMD=1.70,95％CI:0.94 2.46,P＜0.001).The surgical complications were more in PLIF group than in TLIF group (SMD=4.50,95％CI:2.65-7.64,P＜0.001).There were no statistical differences in postoperative interspace height,VAS score,ODI score,improvement rate of JOA score and fusion rate between the two groups [SMD=-0.07,-0.07,0.15,1.43,95％CI:-0.44-0.30,-0.27-0.13,-0.06-0.35,0.75-2.73,0.63-2.15,respectively,all P＞0.05].Conclusions TLIF has significant advantages on decreasing operation time,bleeding volume and risk of surgical complications as compared with PLIF.TLIF and PLIF have the same clinical efficacy on restoring and maintaining postoperative interspace height.
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Durante el abordaje anterior de la región lumbosacra de la columna vertebral es necesario considerar la disposición de los vasos relacionados, evitando así cualquier lesión en ellos. La información sobre la bifurcación de la aorta referida en los textos de anatomía señalan que ésta se realiza a nivel de la cuarta vértebra lumbar. Con el propósito de identificar el nivel de bifurcación de la aorta, realizamos un estudio de registros angiotomográficos obtenidos a través de tomografia axial computarizada de 74 pacientes chilenos, adultos, de ambos sexos, 40 hombres y 34 mujeres. El nivel de bifurcación fue relacionado con los componentes de la columna vertebral, dividiendo las vértebras en tercios. En 10 pacientes (13,5 por ciento) la bifurcación se observó a nivel de la parte inferior de L3; en 17 (23 por ciento) en la parte superior de L4; en 8 (10,8 por ciento) en la parte media de L4; en 26 (35,1) en la parte inferior de L4; en 9 (12,2 por ciento) en la parte superior de L5 y en 4 (5,4 por ciento) en la parte inferior de L5.Los resultados obtenidos muestran que en la mayoría de los individuos estudiados la bifurcación de la aorta se produce a nivel de L4, existiendo menores porcentajes hacia la parte cefálica o caudal de la vértebra mencionada. Esta relación es un aporte al conocimiento anatómico de los vasos abdominales de nuestra población.
During the anterior approach of the lumbosacral spine is necessary considerate the relationships with the vascular system to prevent injuries. The classic anatomy texts describe the aortic bifurcation to level of fourth lumbar vertebra. The objective of this research was determine this level in Chilean individuals. We studied the aortic bifurcation by axial computed tomography in 74 patients, Chilean, adults, of both sexes, 40 men and 34 women. The mentioned level was related with the lumbar vertebras, dividing its body in third parts. We observed the bifurcation at level of inferior third of L3 in 10 patients (13.5 percent); in the superior third of L4 in 17 (23 percent); in the middle third of L4 in 8 (10.8 percent); in the inferior third of L4 in 26 (35.1 percent); in the superior third of L5 in 9 (12.2 percent) and in the inferior third of L5 in 4 (5.4 percent). The results shown that in 2/3 of the cases the aortic bifurcation was to L4 level, being less frequent in proximal or distal vertebras. These relationships are important for the anatomical knowledge of the abdominal vascular system of our people.
Subject(s)
Humans , Male , Female , Aorta, Abdominal/anatomy & histology , Aorta, Abdominal , Lumbar Vertebrae/anatomy & histology , Lumbar Vertebrae , Chile , Sex Characteristics , Tomography, Spiral Computed , Lumbar Vertebrae/blood supplyABSTRACT
Objective To study CT scanning for traumatic thoracolumbar vertebral compression fracture. Methods After routine examination, 16 cases with unsatisfying results were performed CT scanning. Results Wolter classification scheme was involved in and the positions of spinal stenosis and injury were signed with different numbers. The results by CT were consistent with those by operation examination. Conclusion For the diagnosis of traumatic thoracolumbar vertebral compression fracture, CT is more effective than X-ray.
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Objective:To investigate the consistency of two methods in the measurement of bone mineral density in the lateral lumbar vertebra.Methods:The bone mineral densities of the 2nd,3rd and 4th lumbar vertebras in 18 female patients,at a preset side lying position,were measured respectively by two methods(lateral spine analysis,LS and lateral vertebral analysis,LVA) provided by the dual-energy(X-ray) absorptiometry(GE Lunar,Prodigy).The results were recorded and analyzed by SPSS(Version(10.0).) The values of bone mineral density were displayed by boxplot,paired and analyzed by(Wilcoxon's) signed rank test and(Pearson's) correlation analysis.Statistical significance was considered when P(0.05),) and were clearly correlated(P