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Objective To compare the clinical effect and safety of percutaneous vertebroplasty between unipedicular and bipedicular approach for patients with osteoporosis vertebral compressive fractures. Methods A retrospective study was carried out on 147 patients with single osteoporotic vertebral compressive fractures from 2008 to 2014. Ninety-five cases were treated by PVP via a unipedicular approach (unipedicular group) and 52 cases were treated by the bipedicular approach (bipedicular group). The operation time, Cobb, frequency of X-ray exposure,complications like bone cement and postoperative VAS score were compared. Results No significant differences on the VAS score, cobb and complications were found (P > 0.05). However, there were significant differences on the operation time and X-ray exposure frequency (P<0.05). Conclusions No significant differences on clinical effects were found between the unipedicular and the bipedicular approach to percutaneous vertebroplasty for osteoporosis vertebral compressive fractures. However, the unipedicular approach can shorten the operation time and reduce X-ray exposure.
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BACKGROUND:Increasing studies have found that, percutaneous vertebroplasty and bone cement are characterized by few traumas, few bleeding, simple operation, rapid recovery, rapid pain relief, and effective efficacy. However, tumor recurrence, symptom improvement, bone cement leakage and other complications make people controversial. OBJECTIVE: To explore and summarize clinical outcomes and safety of percutaneous vertebroplasty and bone cement for treating symptomatic vertebral hemangioma. METHODS:Fifty-two cases patients of symptomatic vertebral hemangioma (including 21 male and 31 female, aged 16-63 years) were treated with percutaneous vertebroplasty and bone cement. The lesions were found at T5-T12 in 36 cases and at L1-L3 RESULTS AND CONCLUSION: Al 52 patients were folowed up for at least 6 months after the operation. The Visual Analogue Scale and Oswestry Disability Index were significantly increased at 1 day, 3 weeks and 6 months post-surgery, when compared to before surgery (P< 0.05); the modified Macnab evaluation was excelent in 40 cases, good in 7 cases, fair in 3 cases, and poor in 2 cases, and the excelent and good rate was 90%. Only one patient had recurrence at 6 months after surgery and one patient had the leakage of bone cement. No other complications were found. Percutaneous vertebroplasty and bone cement could effectively cure vertebral hemangioma and relieve the pain, which is a safe treatment. in 16 cases. Clinical outcomes such as Visual Analogue Scale, Oswestry Disability Index and modified Macnab criteria, as wel as complication before and after surgery were evaluated.
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BACKGROUND:It has been an urgent problem of how to promote cartilage repair of the knee and shorten the total course through a tissue engineering approach. Fortunately, microfracture plus stem cel transplantation may open up a new path for this issue. OBJECTIVE:To investigate the clinic feasibility of arthroscopic microfracture technique plus stem cel transplantation for repair of articular cartilage injury of the knee. METHODS:From October 2010 to March 2012, a total of 16 patients with articular cartilage injury of the knee were enrol ed, including 12 males and 4 females, with the average age of 38.6 years (16-52). Al cases of cartilage injury were confirmed by arthroscopy. Autologous bone marrow was extracted from patients at 2 weeks before treatment to isolate, culture and amplify bone marrow mesenchymal stem cel s in vitro. The cel culture solution of 3-5 mL (about 107 cel s) was harvested. The articular cavity was clean by arthroscopy and microfracture technique was performed at the area of cartilage injury that was then covered with hemostatic gauze through a minimal y invasive incision and the prepared bone marrow mesenchymal stem cel s were injected. The knee was bandaged with the elastic bandage after aspirating the joint cavity effusion by vacuum suction. Functional exercises were performed early by CPM.RESULTS AND CONCLUSION:After fol ow-up of 4-18 months, there were 13 cases of excel ent, 2 cases of valid and 1 case of ineffective. According to Lysholm knee scores, the average scores were improved from 42 points (33-67 points) to 89 points (75-99 points) at 4 weeks after treatment. The function was satisfied and al patients were fol owed up without recurrence or worse. Under the arthroscopy, the combination of microfracture technique and autologous bone marrow mesenchymal stem cel transplantation is proved to be effective for articular cartilage injury of the knee and it can notably improve the clinic symptoms and recover the function of the knee.