Comparisons on Efficacy of Elcatonin and Limaprost Alfadex in Patients with Lumbar Spinal Stenosis and Concurrent Osteoporosis: A Preliminary Study Using a Crossover Design

STUDY DESIGN: Multicenter prospective study with a crossover design. PURPOSE: The objective of this study is to compare the efficacy of limaprost alfadex (LP) and elcatonin (EL) for lumbar spinal stenosis (LSS) patients with concurrent osteoporosis. OVERVIEW OF LITERATURE: It has been increasingly important to improve quality of life by establishing appropriate conservative treatments for LSS patients with concurrent osteoporosis who will presumably continue to increase due to the percentage of the aging elevations, however there is no prospective study. METHODS: A total of 19 patients with LSS and concurrent osteoporosis were enrolled in this study. The patients were divided into two groups and compared using a crossover design. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and short-form (SF)-8 health survey scale were used for clinical evaluations. RESULTS: There was a significant improvement of buttock-leg pain and numbness in the EL group. A significant improvement of impaired walking function was noted for the LP group according to the JOABPEQ while the rest of the items in the JOABPEQ showed no significant differences. The SF-8 health survey revealed that somatic pains and physical summary scores in the EL group and physical functioning and physical summary scores in the LP group tended to improve but not to any statistically significant extents. CONCLUSIONS: Concomitant uses of EL may be useful in patients who do not respond satisfactorily to the treatments of LP for 6-8 weeks.

Late Reconstruction and Rehabilitation 10-months after Injury in a Patient with unstable Pelvic Ring Fracture / The Japanese Journal of Rehabilitation Medicine

We report a patient who received pelvic reconstruction for unstable pelvic ring fracture with severe open-book deformity after 10 months of conservative therapy and regained the ability to walk. The present report indicates that patients with unstable pelvic ring fractures should undergo reduction and fixation in the early period. Unstable pelvic ring fracture is a result of high energy trauma. It is difficult to find the best time for intervention once it has been delayed. This AO Type C3 unstable pelvic ring fracture was examined by CT imaging for pelvic deformity. Independence in activities of daily living (ADL) was evaluated using the Functional Independence Measure (FIM). After pelvic ring deformity was reduced by an external fixation-traction system, anterior fixation was performed and contracture of short external rotators was released. The patient's hip function normalized after the procedures and he was able to walk again 6 months later. Concomitant nerve paralysis also recovered after the reduction and fixation of the pelvic deformity. Unstable pelvic ring fractures may progress to pelvic deformity and adversely affect the patient's ADL unless they are managed with reduction and fixation in the early period. Unstable pelvic ring injury should primarily be treated with reduction and fixation in the acute phase.