Analysis of clinical efficacy of modified cross-puncture vertebroplasty in the treatment of osteoporotic vertebral compression fracture / 上海交通大学学报（医学版）

Objective: To compare the clinical efficacy of cross puncture technique with traditional puncture technique in the treatment of osteoporotic vertebral compression fracture (OVCF). Methods: Patients with OVCF treated with percutaneous vertebroplasty (PVP) were selected. According to the puncture method, the patients were divided into cross puncture group and traditional puncture group, with 70 cases in each group. The clinical data, imaging parameters, pain score, dysfunction score, overall satisfaction and related complications of the two groups were compared before and after operation, and the clinical efficacy of the two groups was evaluated. Results: Compared with the traditional puncture group, the wedge angle in the cross puncture group decreased at 6 and 12 months after operation (both P=0.000), while the leading edge height increased (P=0.012, P=0.000). During the follow-up, there was no significant difference in pain score and dysfunction score between the two groups. Compared with the traditional puncture group, the proportion of the excellent and great grades (Odom standard) of patients in the cross puncture group was higher (P=0.000, P=0.003), and the incidence of vertebral collapse, kyphosis deformity and spinal stenosis were lower (P=0.000, P=0.002, P=0.031). Conclusion: At 6 and 12 months after operation of cross puncture PVP, the follow-up changes of wedge angle and leading edge height of vertebral body were smaller than those of traditional puncture technique, that is, more stable. The incidence of vertebral collapse was lower, and the overall satisfaction of the curative effect was higher.

Dosimetry verification of virtual wedge using a two-dimensional ionisation chamber array / 中华放射肿瘤学杂志

Objective To investigate the virtual wedge (VW) dosimetric parameters with the ionization chamber array Matrixxenvlution.Methods Using Matrixxenvlution and solid water to measure and calculate Siemens accelerator's VW angle and VW factors of different fields and compare the wedge field dose distribution to that of treatment planning system (TPS) by gamma analysis,summarized the measurement results of 50 times.Results The γ pass rate (3 mm/ 3％) of 15° and 30° VW in both direction were (91.47 ± 1.76)％,(92.99 ± 1.54)％ and (93.27 ± 1.24)％,(93.27 ± 1.68)％,respectively,with the increase of filed size and the VW angle,but for 20 cm ×20 cm field and VW 60°,the result was not very good.The largest angle deviation ＜ 2° except small field size and wedge angle,VW factors were approximately equal to 1,the maximum deviation was no more than 0.05,plan dose distribution and the measured dose distribution have good consistency except large field with large wedge angle.Conclusions Matrixxenvlution used in the measurement of VW dosimetric parameters which can obtain all parameters for angle calculation and dose plane analysis with only once positioning,and become more rapid,convenient,economical and practical one of quality assurance tools for VW dose verification.

The Effect of Vertebral Wedge Angle to the Change of Kyphotic Angle by the Posterior Instrumentation Method in Thoracolumbar Spine Fracture / 대한척추외과학회지

STUDY DESIGN: Retrospective study OBJECTIVES: To examine the effect of transpedicular screw fixation on fractured vertebrae about the vertebral wedge angle (VWA) after posterior instrumentation of the thoracolumbar fracture, determine the effect of reduced VWA on the change in the Kyphotic angle (KA), and minimize loss of reduction of KA. SUMMARY OF THE LITERATURE REVIEW: Maintenance of the KA of a thoracolumbar fracture after surgery is important for the radiologic and functional outcome. MATERIALS AND METHODS: Forty patients, who had undergone posterior instrumentation in a thoracolumbar fracture between February 2006 and February 2008 and followed-up for more than one year, were enrolled in this study. The patients were divided into two groups according to transpedicular screw fixation (Group A) or not (Group B) including fractured vertebrae. The evaluation was performed by measuring the changes in the KA and VWA taken after the injury, immediate after surgery and 1 year after surgery. RESULTS: There was correlation between groups A (transpedicular screw fixation on fractured vertebrae) and B (no transpedicular screw fixation on the fractured vertebrae) regarding the correction of the VWA and the loss of correction KA, (p<0.05). CONCLUSIONS: Reduction of the VWA is an important factor for preventing reduction loss of the KA, and transpedicular screw fixation including fractured vertebrae would help reduce the VWA. Therefore, the operator must pay attention to the increase in VWA to maintain the KA through short segment transpedicular screw fixation including fractured vertebrae.

Postural Reduction in Compression Fracture of Spines

121 patients with cervical(45 patients), thoracolumbar(76 patients) compression or mild burst fractures from January 1984 to December 1994 were studied:98 patients were treated postural reduction with hyperextension posture and 23 patients were with postural reduction and surgical methods. We compared the initial and post-reduction compression height ratio, wedge angle and kyphosis angle of compression fractures. The results were not only expansion of a compressed vertebral body but also successful fusion. The neurological recovery status according to Frankel classification was also improved after postural reduction. Most of the compression fractures or stable burst fractures of the cervical, thoracolumbar spines can be restored by the postural reduction.

Postural Reduction for the Compression Fracture of the Thoracolumbar Spines

Postural reduction was performed in 20 cases of the closed thoracolumbar compression fracture using a soft pillow from January 1982 to June 1985. The results were summarized as following: 1) The compression fracture or mild burst fracture of the thoracolumbar spines can be restored by the postural reduction in hyperextension position using a soft pillow under the back of thoracolumbar junction. 2) The postural reduction resulted in not only expansion of a compressed vertebral body but also successful fusion. 3) It was most satisfactory when the postural reduction was performed as early as possible, at least within 1 week after injury. 4) The postural reduction is considered a simple and convenient treatment of the thoracolumbar compression fracture.