Effects of Zoledronic Sodium on Thoraco-lumbar Spine Fracture / 中国药房

OBJECTIVE:To investigate the effects of zoledronic sodium on fracture healing in patients with thoraco-lumbar spine fracture(TLSF). METHODS:82 patients with TLSF were randomly divided into observation group and control group with 41 cases in each group. All applied pedicle screw fixation. After operation,control group received conventional therapy as calcium supplement,and observation group was additionally given intravenous injection of zoledronic sodium 5 mg on the basis of control group. The change of Imaging parameters 6 months after operation were compared between 2 groups,and the changes of serum PINP,β-CTX and lumbar spine bone mineral density,and fracture healing time were compared 3,6,12 months after operation. RESULTS:The vertebral height,sagittal index,Cobb’s angle of 2 groups were improved 6 months after operation,compared with before operation,with statistical significance (P0.05);the levels of β-CTX and PINP in observation group were lower than that in control group 3,6,12 months after operation, there was statistical significance 3 month after operation(P<0.01);BMD of observation group was higher that of control group 3, 6,12 months after operation,with statistical significance(P<0.05);the fracture healing time of observation group was(13.25± 1.23)weeks,which was shorter than that of control group(14.54±1.49)weeks,with statistical significance(P<0.01). CONCLU-SIONS:For patients with TLSF,postoperative treatment of zoledronic sodium can increase lumbar spine bone mineral density and promote healing.

Clinico-radiologic Findings of the Whole Spine in Patients with Chronic Low Back Pain

OBJECTIVE: The purpose of this study was to evaluate the whole spine of the patients with chronic low back pain. METHOD: The cervico-thoraco-lumbar spine were evaluated in 128 patients with chronic low back pain. We analyzed radiologic and clinical findings of the cervico-lumbar spine and electrodiagnostic findings. RESULTS: Most of all cases showed abnormal findings in plain radiography and electrodiagnostic study. The radiologic findings were as follow: cervical X-ray with straightening of cervical lordotic curve in 85 cases; thoracic X-ray with scoliosis in 55 cases; lumbar X-ray with disc space narrowing in 85 cases. The electrodiagnostic study revealed lumbosacral radiculopathy in 87 cases. There were significant positive relationship between increased lumbosacral angle and straightening of cervical lordotic curve, and between lumbar scoliosis and thoracic scoliosis. CONCLUSION: Cervico-thoracic spinal abnormalities were shown in most of the patients with chronic low back pain. Therefore, The evaluation of whole spine would be needed comprehensive rehabilitation approach for the patients with chronic low back pain.

Six Cases of Thoraco-lumbar Tuberculosis Treated by Anterior Decompression and Fusion with or withought Instrumentation

The anterior decompression and fusion have been the choice of surgical treatment for spinal tuberculosis since 1960. From April 1995 to April 1996, we operated on six patients of thoraco-lumbar tuberculosis. The procedure consisted of anterior decompression through corpectomy, stabilization with anterior instrument and bone graft with or without Titanium MESH. MRI provides a valuable information about the extent of the disease in multiple planes, thereby helping surgeons in planning of the operation. The thoracic spine was involed in four patients, the lumbar spine in two. On average, two vertebral bodies were involved. Anterior and middle column of spine were involved in all patients, but posterior column was intact in all patients. Disc space involvement was seen in all patients. Paraspinal abscess was observed in three patients. Epidural compression of the spinal cord or cauda equina was noted in all patients. Four patients showed neurological improvements and relief of pain. However, the recovery of two remaning paraplegic patients was not remarkable. There was no single case associated with persistence or recurrence of infection after instrumentation.

Segmental Spinal Instrumentation in the Management of Fracture and Fracture-Dislocation of the Thoraco-Lumbar Spine / 대한정형외과학회잡지

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.