ABSTRACT
Objective To observe the influence of spine kyphotic deformity on postmenopausal osteoporosis patients' pulmonary function and physical activity,and then provide a guide for the rehabilitation training of patients with osteoporosis and a kyphotic spine.Methods Sixty postmenopausal women with osteoporosis were recruited from the osteoporosis outpatients of the Third Hospital of Peking University.Half of them suffered from spine kyphosis (the spine kyphosis group) and the other half did not (the non-spine kyphosis group).There was no significant difference in the average ages and body mass indexes of the two groups.The research applied Cobb's angle and wall-occiput distance (WOD) to assess kyphosis severity,a visual analogue scale (VAS) to evaluate the patient's pain level,plus pulmonary function assessments and thoracic expansion assessments in both groups simultaneously,and the 6-minute walking test (6-MWT) to assess the patients' physical activity.Results The spine kyphosis group said they experienced significantly more pain than the non-kyphosis group,and they had worse pulmonary function and poorer physical activity.These differences were statistically significant.Pulmonary function was significantly correlated with the severity of spine kyphosis,back ache,thoracic expansion as well as physical activity.Conclusion Spine kyphosis deformity can aggravate back ache among postmenopausal osteoporosis patients,and affect their pulmonary function and physical activity.When planning clinical exercise training for such patients,physicians should pay attention to respiratory function training so as to improve the patients' pulmonary function,physical activity and endurance as much as possible,and thus improve their quality of life.
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[Objective] To analyze clinical assessment and surgical treatment of rigid cervical kyphosis. [Methods]Thirty-nine cases of rigid kyphosis were retrospectively analyzed (13 cases of idiopathic kyphosis, 8 cases of kyphosis caused by laminectomy, 11 cases caused by old fractures, and 7 cases associated with cervical degenerative kyphosis). The preoperative JOA score was 9.71 ? 2.25, and kyphosis Cobb angles were 9 ?~72 ? (average 22.4 ?). All clinical evaluation had been done to patients and different surgical methods had been implied according to their different clinical manifestations and imaging features, including simple anterior surgery, the one-step anterior-posterior combined surgery, and the two-step of anterior-posterior combined surgery.[Results]The patients were followed up from12 to 36 months (average, 27 months).In the periods of intra-operation or post-operation,no major complication occurred. Neck pain disappeared and neural functions partially recovered postoperatively. Bone graft fusion was achieved.Postoperative JOA score was 14 ? 2.73 (and compared with preoperative t =-9.68 P
ABSTRACT
[Objective]To explore the clinical character and the treatment method of wedge-shaped vertebral osteotomy,expanding bone graft and spanning segment pedicle screw-rod system fixation from posterior approach to the thoracolumbar kyphosis caused by old fracture.[Method]From June 2003 to May 2008,26 cases of kyphosis deformity at thoracolumbar segment were treated with wedge-shaped vertebral osteoctomy and long segment pedicle screw-rod internal fixation,including 19 males and 7 females and aging 16-45 years(average age:24.2 years).All kyphosis deformity were caused by old thoracolumbar fracture and patients suffered from back pain.The average disease history were 12.6 years.All the sigittal kyphosis Cobb's angles were more than 40 degree cases.Sixteen patients complicated with nervous symptom.Among them 18 cases were given wedge-shaped vertebral osteoctomy and long segment pedicle screw internal fixation,8 cases were given expanding bone graft in anterior of vertebra after osteotomy.The kyphosis angles from radiographs were given compared between pre-and postoperatively,and complications were given analysis too.[Result]Twenty-two patients had been followed up for 12-48 months(average time:34.6 months),all patients' kyphosis angles were corrected satisfactory,the extend of right angle were 86.45%?4.56%.Besides mesenteric artery compressed syndrome happened in 1 patient,other complication was rare.[Conclusion]This method can correct the kyphosis deformity immediately in operation,its correct extent is large,expanding bone graft in anterior of vertebra after osteotomy can reduce the spine shorten and spinal cord injury rate.