Expression of SF3B1, UBE2V2 and SETD2 and association with osteoporotic vertebral fractures inelderly patients / 中华内分泌外科杂志

Objective:To explore the relationship between the expression of SF3B1, UBE2V2, SETD2 and osteoporotic vertebral fracture (OVF) in elderly patients.Methods:Peripheral blood samples were collected from 31 elderly patients with osteoporotic vertebral fractures (VF group) and 16 elderly patients with osteoporotic non-vertebral fractures (NVF group) in Yantai Mountain Hospital. RNA was extracted for transcriptome sequencing to screen for differentially expressed genes. VF related genes were screened by Gene Ontology (GO) analysis, protein protein interaction (PPI) network analysis and ROC curve analysis. Qrt-pcr was used to detect gene expression levels.Results:Compared with NVF group, 691 genes were up-regulated while 131 genes were down regulatedin VF group. qRT-PCR results revealed that, compared with NVF patients (1.55±0.33) (1.70±0.33) (1.64±0.33) , SF3B1 (1.83±0.23) ( t=2.84, P=0.008) , UBE2V2 (2.24±0.43) ( t=3.91, P<0.001) expression were increased while SETD2 (1.18±0.46) ( t=3.25, P=0.003) expression was decreased in peripheral blood of VF patients. ROC curve analysis showed that the AUCs of SF3B1, UBE2V2 and SETD2 in VF were 0.8034 ( P=0.007) , 0.8145 ( P=0.005) and 0.7863 ( P=0.0014) , respectively. Conclusion:SF3B1, UBE2V2 and SETD2 are highly correlated with OVF in elderly patients, and are of great value in the diagnosis and prediction of OVF.

Influence of Vertebral Bone Marrow Edema on Outcome in Non-Acute Osteoporotic Patients Treated with Percutaneous Vertebroplasty

STUDY DESIGN: Prospective cohort study. PURPOSE: To prospectively investigate the influence of presence of bone marrow edema (BME) in non acute osteoporotic verterbral compression fractures on postoperative clinical outcome in patients treated by percutaneous vertebroplasty (PV). OVERVIEW OF LITERATURE: Although PV is widely used to treat osteoporotic collapsed vertebral compression fractures (VCF); little is known about the influence of BME in osteoporotic VCF or about its relation with relief of pain. METHODS: Sixty seven patients with non acute osteoporotic verterbral compression fractures treated with PV. They were divided into edema group (56 patients with apparent vertebral BME in their magnetic resonance [MR] images), and non edema group (11 patients with no vertebral BME detected in their MR images). Pain was evaluated one week, one month, six months, and one year post procedure using visual analogue scale. Statistical analysis including a 2-tailed t test comparing postoperative data with preoperative values was done. RESULTS: A good clinical response to PV procedure was seen in all patients. Significant difference was seen between two groups in one week, and one month follow up periods. Regarding pain relief in the other periods of follow up, no significant difference was seen between two groups. CONCLUSIONS: PV resulted in significantly clinical improvement in patients with BME pattern than in those without in one week and one month follow up periods. But the absence of vertebral BME did not influence pain relief in patients with osteoporotic VCFs in six months, and one year post procedure.

Influence of Vertebral Bone Marrow Edema on Outcome in Non-Acute Osteoporotic Patients Treated with Percutaneous Vertebroplasty

STUDY DESIGN: Prospective cohort study. PURPOSE: To prospectively investigate the influence of presence of bone marrow edema (BME) in non acute osteoporotic verterbral compression fractures on postoperative clinical outcome in patients treated by percutaneous vertebroplasty (PV). OVERVIEW OF LITERATURE: Although PV is widely used to treat osteoporotic collapsed vertebral compression fractures (VCF); little is known about the influence of BME in osteoporotic VCF or about its relation with relief of pain. METHODS: Sixty seven patients with non acute osteoporotic verterbral compression fractures treated with PV. They were divided into edema group (56 patients with apparent vertebral BME in their magnetic resonance [MR] images), and non edema group (11 patients with no vertebral BME detected in their MR images). Pain was evaluated one week, one month, six months, and one year post procedure using visual analogue scale. Statistical analysis including a 2-tailed t test comparing postoperative data with preoperative values was done. RESULTS: A good clinical response to PV procedure was seen in all patients. Significant difference was seen between two groups in one week, and one month follow up periods. Regarding pain relief in the other periods of follow up, no significant difference was seen between two groups. CONCLUSIONS: PV resulted in significantly clinical improvement in patients with BME pattern than in those without in one week and one month follow up periods. But the absence of vertebral BME did not influence pain relief in patients with osteoporotic VCFs in six months, and one year post procedure.

Percutaneous Vertebroplasty: A New Serial Injection Technique to Minimize Cement Leak

STUDY DESIGN: This is a prospective cohort study. PURPOSE: This study discusses a new technique for injecting cement in the affected vertebrae. OVERVIEW OF LITERATURE: Since introduction of vertebroplasty to clinical practice, the cement leak is considered the most frequent and hazardous complication. In literature, the cement extravasation occurred in 26%-97% of the cases. METHODS: A hundred and twenty-three patients underwent vertebroplasty using the serial injection technique. The package of the cement powder and the solvent was divided into five equal parts. Each part of the powder and the solvent was mixed as a single dose and injected to the affected vertebra. The duration between subsequent injections was 10 minutes. Each injection consisted of 1-1.5 mL of cement. RESULTS: This new technique gives the surgeon enough time to make multiple separate injections using the same package. The time interval between injections hardens the cement just enough so that it does not get displaced by the next cement injection. This technique gives time to the preceding injected cement to seal off the cracks and cavities in the vertebra, and subsequently leads to a significant decrease in cement leak (p<0.001), as compared to literature. CONCLUSIONS: This study demonstrates a previously unreported technique for vertebroplasty that adds more safety to the procedure by significantly decreasing cement leak. It also makes the surgeon more relaxed due to time intervals, giving him more self-confidence whilst performing the procedure.

Radiographic Detection of Osteoporotic Vertebral Fracture without Collapse

BACKGROUND: On retrospective basis, we investigated the detection of osteoporotic vertebral fractures (OVFs) without radiologic collapse using a modified Yoshida's classification, which was designed by the authors. METHODS: We observed 82 cases in 76 patients with confirmed OVFs without collapse at the thoracolumbar junction. The following factors were measured: age, gender, body mass index (BMI, kg/m2), bone mineral density (BMD, mg/cm3), type of a modified Yoshida's classification. The correct diagnosis rate for the presence and location of OVFs and the correct diagnosis rate according to the morphological type by a modified Yoshida's classification of the OVFs were analyzed. RESULTS: The mean BMI was 21.2; mean BMD, 44.1; and T-score, -4.4. As for the four subtypes of anterior cortical morphological change, there were 14 cases of the protruding type, 12 cases of the indented type, 5 cases of the disrupted type and 8 cases of the prow type. As for the three subtypes of endplate depression, there were 20 cases of upper endplate depression, 12 cases of lower endplate depression and 11 cases of endplate slippage type. According to the examiners, there was a significant difference between being informed before and after the modified Yoshida's classification. For the relationship of examiners and the type of fracture, there was a significant difference between being informed before and after the modified Yoshida's classification, particularly in the protruding type and the upper plate type. CONCLUSIONS: A modified Yoshida's classification can be helpful for the diagnosis of OVFs without radiologic collapse in a simple radiograph.

The Comparison of Bone Scan and MRI in Osteoporotic Compression Fractures

STUDY DESIGN: Retrospective study. PURPOSE: To estimate the usefulness of bone scan and magnetic resonance imaging (MRI) for the diagnosis of new fracture in osteoporotic vertebral fractures. OVERVIEW OF LITERATURE: The diagnosis of new fractrure in osteoporotic vertebral fractures requires simple X-ray and supplementary studies. METHODS: We analyzed 87 vertebrae in 44 patients, who diagnosed with osteoporotic vertebral fractures using bone scan and MRI within 2 months interval between August 2001 and July 2008. We compared hot uptakes in bone scan with MRI findings such as new fractures, old fractures and degenerative lesions. RESULTS: Hot uptakes in bone scan was matched to 48 new fractures, 26 old fractures and 13 degenerative lesions in MRI findings. It was 55% of concordance between hot uptakes in bone scan and new fractures in MRI. The rate of new vertebral fractures confirmed by MRI according to 1 level hot uptakes in bone scan was 96%, 2 levels was 50% and 3 more levels was 36%. CONCLUSIONS: The diagnosis of new fracture in osteoporotic vertebral fractures requires simple X-ray and supplementary studies such as bone scan and MRI. We recommend more careful interpretation in multiple osteoporotic vertebral fracture patients about hot uptake lesions of bone scan.

Percutaneous vertebroplasty: a comparison between the procedure using the traditional and the new side-opening cannula for osteoporotic vertebral fracture / Vertebroplastia percutânea: uma comparação entre o procedimento usando a cânula tradicional e a nova cânula de orifício lateral para fratura vertebral osteoporótica

A total of 47 percutaneous vertebroplasties (PVs) were performed for osteoporotic vertebral fractures in 31 patients, 25 PVs were performed using the frontal-opening cannula (FOC) and 22 using the new side-opening cannula (SOC), randomly distributed. The incidence of cement extrusion was 27 percent with the SOC, and 68 percent with the FOC, all asymptomatic (p<0.01). The pain control was similar for both groups, with good improvement of pain in most of the patients, and there were no clinical relevant complications. The cement leakage can be significantly reduced with this new SOC, which allows for a better cement injection toward the center of the vertebral body, increasing the safety of the procedure, with no increase in cost.

Um total de 47 vertebroplastias percutâneas (VP) foram realizadas para fraturas vertebrais osteoporóticas em 31 pacientes, 25 VP foram realizadas usando-se a cânula de orifício frontal (COF) e 22 com a nova cânula de orifício lateral (COL), distribuídos randomicamente. A incidência de extrusão de cimento ortopédico ocorreu em 27 por cento com a COL, e 68 por cento com a COF, todas assintomáticas (p<0,01). O controle da dor foi similar em ambos os grupos, com boa melhora da dor na maioria dos pacientes, sem complicações clínicas relevantes. A extrusão do cimento pode ser significativamente reduzida com esta nova COL, que permite uma melhor injeção do cimento para o centro do corpo vertebral, aumentando a segurança do procedimento, sem aumento no seu custo.